RESUMO
We describe three cases of acute pericardial effusion during endovascular treatment of superior vena cava (SVC) syndrome, one of which resulted in fatal pericardial tamponade. SVC syndrome results from impaired venous return from the head and upper extremities to the right atrium. Malignancy and catheter-induced SVC stenosis accounts for the majority of cases of SVC syndrome. Endovascular therapy is the treatment of choice for SVC syndrome due to its rapid relief of symptoms and low morbidity. Acute pericardial effusion and pericardial tamponade may result from inadvertent extraluminal traversal of the SVC in the so-called danger zone above the right atrium, as well as secondary to dissection of wires in a location where fascial planes have been altered by neoplasia or inflammation.
RESUMO
Retained placenta is a serious cause of postpartum hemorrhage. Compounding this problem is the rare finding of a retained placenta accreta. Different authors have presented management options for retained placenta accreta that include methotrexate, uterine artery embolization, dilation and curettage, hysteroscopic loop resection, and hysterectomy. We report here on a patient who was diagnosed with a retained placenta accreta and underwent successful conservative treatment with uterine artery embolization followed by hysteroscopic morcellation. Whereas other methods have failed due to bleeding and/or infection, this case illustrates a potential new means of addressing this challenging obstetrical complication.