Acquired Uterine Arteriovenous Malformation: Treatment With Uterine Artery Embolization

Abstract

Enhanced myometrial vascularity/uterine arteriovenous malformations (EVM/AVM) are a rare cause of vaginal bleeding that can result in life-threatening hemorrhage if left untreated. Enhanced myometrial vascularity/uterine arteriovenous malformations arise from an abnormal connection between arteries and veins without an intervening capillary network and can be acquired as a result of retained products of conception, uterine trauma, or surgical intervention. Enhanced myometrial vascularity/uterine arteriovenous malformations are typically present in women of childbearing age with intermittent to profuse vaginal bleeding symptoms. The diagnosis is typically made by transabdominal or transvaginal ultrasound with color Doppler followed by computed tomography angiography or magnetic resonance imaging to assess the extent of the malformation and visualize any feeding arteries. Treatment varies based on symptoms, age, patient preferences, and desire for future fertility and includes conservative therapy, uterine artery embolization, and hysterectomy. We report 3 cases of EVM/AVM, which were imaged and diagnosed utilizing ultrasonography and successfully treated with uterine artery embolization.