Steri L, Barbieri P, Gigante L, Posa A. Prophylactic occlusion balloon in placenta abnormalities: What every interventional radiologist needs to know. World J Radiol 2025; 17(7): 107737 [DOI: 10.4329/wjr.v17.i7.107737]
Corresponding Author of This Article
Alessandro Posa, MD, Department of Diagnostic Imaging and Radiation Oncology, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Largo Agostino Gemelli 8, Rome 00168, Lazio, Italy. alessandro.posa@policlinicogemelli.it
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Jul 28, 2025; 17(7): 107737 Published online Jul 28, 2025. doi: 10.4329/wjr.v17.i7.107737
Prophylactic occlusion balloon in placenta abnormalities: What every interventional radiologist needs to know
Lorenzo Steri, Pierluigi Barbieri, Lavinia Gigante, Alessandro Posa
Lorenzo Steri, Department of Diagnostic Imaging, Ospedale Isola Tiberina Gemelli Isola, Rome 00186, Lazio, Italy
Pierluigi Barbieri, Alessandro Posa, Department of Diagnostic Imaging and Radiation Oncology, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome 00168, Lazio, Italy
Lavinia Gigante, Department of Woman, Child and Public Health, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome 00168, Lazio, Italy
Author contributions: Steri L and Posa A were responsible for conceptualization, data curation, and project administration; Steri L, Barbieri P, and Posa A were responsible for methodology; Gigante L and Posa A were responsible for visualization; Posa A was responsible for writing, reviewing, editing, and supervision; Steri L, Barbieri P, Gigante L, and Posa A were responsible for the investigation, resources, and writing the original draft; All authors read and agreed to the published version of the manuscript.
Conflict-of-interest statement: All authors declare no conflicts of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Alessandro Posa, MD, Department of Diagnostic Imaging and Radiation Oncology, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Largo Agostino Gemelli 8, Rome 00168, Lazio, Italy. alessandro.posa@policlinicogemelli.it
Received: March 31, 2025 Revised: April 21, 2025 Accepted: June 9, 2025 Published online: July 28, 2025 Processing time: 119 Days and 9.6 Hours
Abstract
Placenta abnormalities, which are collectively termed as placenta accreta spectrum (PAS), are increasing globally in the female population due to the large number of cesarean sections performed worldwide. PAS represents a rare but life-threatening occurrence that can lead to an increased risk of postpartum hemorrhage due to the abnormal infiltration of the chorionic villi in the uterine wall up to the adjacent structures. Performing a prophylactic occlusion of the iliac arteries for a brief amount of time using balloon-occlusion endovascular catheters in patients with PAS can help control unwanted blood losses during cesarean delivery or postpartum demolition surgery. The aim of this narrative minireview was to provide an overview of the aspects about prophylactic occlusion with endovascular balloons in patients with PAS and to analyze current evidence on this topic. In particular, this minireview included an overview of indications, patient selection, type of materials and devices used, technical advice and suggestions, clinical outcomes, and complications to give every interventional radiologist as well as every gynecologist and midwife all the information that is needed to address this particular condition in a safe and prompt manner.
Core Tip: Aim of this narrative minireview is to give a comprehensive overview on the use of prophylactic occlusion balloon, in preventing major blood losses in patients with placenta accreta spectrum, undergoing cesarean delivery or demolition surgery. The heterogeneity of the results of different studies on this topic, the extreme delicacy of the type of patients to be treated, often very young, are some of the key points on which there is a need to clarify the knowledge on the argument. As in many other pathologies, there is no univocal treatment validated for all patients, but the correct treatment must be tailored for each individual case, hence this work shows all the possible treatments available.
