devascularizzazione

Devascularization is a surgical and interventional radiology technique that aims to interrupt the blood supply to a target organ, tissue, or lesion. It is achieved by ligating or clipping feeding arteries, applying thermal or ultrasonic coagulation, or by endovascular occlusion of the vessels that nourish the target. By reducing arterial inflow and perfusion, devascularization can decrease bleeding, facilitate surgery, or lessen the vascularity of a lesion.

In obstetrics and gynecology, uterine devascularization refers to procedures that interrupt blood flow to the uterus, typically by ligating the uterine arteries and sometimes the internal iliac or ovarian arteries. The goal is to control severe postpartum hemorrhage or to enable myomectomy while aiming to preserve uterine function. Devascularization may be used as an adjunct to other measures or, in some cases, as an alternative to hysterectomy when bleeding is life-threatening.

Devascularization is also used in oncologic and general surgery to reduce intraoperative blood loss by devascularizing tumors or highly vascular lesions, such as in liver or pelvic surgery. When performed endovascularly, selective arterial embolization can achieve a similar effect without open surgery and is a common alternative or adjunct to surgical ligation.

Risks include tissue ischemia of non-target areas, necrosis, infection, and injury to adjacent structures. In obstetric cases, insufficient control of hemorrhage may necessitate hysterectomy. As with any vascular intervention, the choice of technique depends on the clinical context, goals, and available expertise.