scholarly journals Uterine artery embolization for the treatment of symptomatic myomas in Brazilian women

2003 ◽  
Vol 121 (5) ◽  
pp. 185-190 ◽  
Author(s):  
Maurício Sena-Martins ◽  
Cecilia Maria Roteli-Martins ◽  
Valdir Tadini ◽  
Gustavo Antonio de Souza ◽  
Nestor Kisilevzky ◽  
...  
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Tertiary Care ◽  
Reproductive Age ◽  
Benign Tumors ◽  
Artery Embolization ◽  
Menstrual Flow ◽  
Gynecological Examination ◽  
The Mean ◽  
Uterine Volume

CONTEXT: Uterine myomas are benign tumors that mostly occur in women of reproductive age at a frequency ranging from 20 to 25%. The symptoms are increased menstrual flow, pain and compressive signs. New treatments have been proposed and uterine artery embolization is one of them. OBJECTIVE: To evaluate the effects of treatment by embolization of the uterine artery, in women with symptomatic myomas. Uterine and dominant myoma volumes and the major symptoms were evaluated before treatment and 12 weeks later. TYPE OF STUDY: Open clinical trial. SETTING: A tertiary-care women's hospital. PARTICIPANTS: The study was conducted on 32 women with symptomatic single or multiple myomas of the uterine body, seen at the outpatient unit from May 2000 to September 2001. MAIN MEASUREMENTS: The patients were submitted to gynecological examination and abdominal and endovaginal pelvic ultrasonography, and the examinations were repeated 12 weeks after the first procedure. Uterine artery embolization using PVA (polyvinyl alcohol) particles of 355-700 µ was performed by catheterization of the right femoral artery in 30 women and by bilateral catheterization in two. RESULTS: Before embolization, the mean uterine volume of the 32 women was 455 cm³ and the mean volume of the dominant myoma was 150 cm³. Twelve weeks after embolization, the mean uterine volume was 256 cm³ and the mean volume of the dominant myoma was 91 cm³, with p < 0.01 in both cases. Twelve weeks after the treatment, all the women answered a questionnaire, which showed that 71% had improvement in menstrual regularity, 90% decreased menstrual volume and 81% shortened menstrual duration. The most frequent immediate post-procedure symptoms, established as complications, were pain (100%) and fatigue (34%). One woman had myoma degeneration and was submitted to myomectomy. CONCLUSION: The significant reduction in uterine and dominant myoma volume confirms the validity of the treatment of symptomatic myomas by the technique of uterine artery embolization in Brazilian women. There was significant reduction in menstrual flow and duration, as well as better cycle regularity in the women studied. The few adverse effects observed in the sample studied mainly involved pain immediately after embolization.

Uterine artery embolization in uterine fibroids patients of reproductive age and its role in shaping of autoimmune oophoritis

2016 ◽  
Vol 3 (2) ◽  
pp. 81-87
Author(s):  
Elena A. Sosnova
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Ovarian Function ◽  
Clinical Laboratory ◽  
Uterine Fibroids ◽  
Treatment Method ◽  
Reproductive Age ◽  
Long Term Results ◽  
Artery Embolization ◽  
Premature Failure

In women of the reproductive age who have preserved the uterus after uterine artery embolization (UAE) and are interested in restoring fertility, the clinical evaluation of long-term results of this treatment method was executed with the use both of a questionnaire survey (n = 98), and determination of the status of ovarian reserve, ovaries, thyroid gland(n = 52). Performed retro- and prospective clinical-laboratory and instrumental methods of the investigation allowed to reveal a higher risk of the development of remote complications of UAE, in particular in the premature failure of ovarian function.

scholarly journals Study of uterine artery embolization: a newer modality in secondary PPH

2018 ◽  
Vol 7 (2) ◽  
pp. 452
Author(s):  
Sweta Agrawal ◽  
Ratnamala Thakur ◽  
Shikha Sonker
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Blood Product ◽  
Tertiary Care ◽  
Clinical Effectiveness ◽  
Care Hospital ◽  
Obstetric Hemorrhage ◽  
Artery Embolization ◽  
Mortality And Morbidity ◽  
Maternal Mortality And Morbidity

Background: Postpartum hemorrhage remains a major cause of both maternal mortality and morbidity worldwide. This study reflects the clinical outcomes including clinical effectiveness, and safety of uterine artery embolization (UAE) for the treatment of obstetrical uterine hemorrhage at a tertiary-care hospital, in terms of secondary PPH.Methods: The data were collected as a retrospective study from SAMC and PGI obstetric and gynecology department 12 women with secondary pph were included in the study.Results: With the use of uterine artery embolization 12 women were successfully treated amongst them maximum patients were in 26-35 yrs of age and mean age of women were 32.4yrs and gravidity of patients presenting with pph is 3 or more.Conclusions: Selective UAE is a safe and effective method to control obstetric hemorrhage. Blood product requirements after UAE were low, and the surgical risks and absolute loss of fertility associated with hysterectomy were avoided.

scholarly journals Role of collateral embolization in addition to uterine artery embolization followed by hysteroscopic curettage for the management of cesarean scar pregnancy

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Guodong Zhang ◽  
Jijun Li ◽  
Jun Tang ◽  
Lei Zhang ◽  
Dechao Wang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Pelvic Pain ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Artery Embolization ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
The Mean ◽  
Baseline Characteristics ◽  
Β Hcg

Abstract Background The aim of this study was to assess the feasibility, safety and outcome of the embolization of non-gonadal collateral supplying gestational sac (GS) in addition to uterine artery embolization (UAE), followed by hysteroscopic curettage for the management of cesarean scar pregnancy (CSP). Methods A retrospective study was undertaken from January 2012 to September 2018 in 24 CSP patients in whom non-gonadal collaterals supplying GS were identified by arterial angiography performed immediately after UAE. These patients underwent attempt collateral embolization in addition to UAE, followed by hysteroscopic curettage for the management of CSP. The 24 patients were divided into two groups based on whether they underwent technically successful collateral embolization (UAE-SCE group) or failed collateral embolization (UAE-FCE group) in addition to UAE. The baseline characteristics and clinical outcomes including time for serum β-human chorionic gonadotropin (β-hCG) levels normalization, blood loss, secondary anemia, and pelvic pain were compared between the two groups. The paired t test and Man Whitney test were used for comparisons of discrete and numerical variables, respectively. Results Collateral embolization was techinically successful in 16 (66.7%, 16/24) patients and failed in the other 8 (33.3%, 8/24) patients. There were no significant differences between the two groups in baseline characteristics. The mean blood loss and secondary anemia in the UAE-SCE group were significantly less than UAE-FCE group. No significant difference was found between the two groups in the mean time for β-hCG levels normalization and pelvic pain. Conclusions During the management of UAE combined with hysteroscopic curettage for CSP, additional embolization of non-gonadal collateral supplying GS during UAE is feasible and safe in patients with non-gonadal collateral supplying GS, and the additional embolization of the collateral may reduce blood bloss related to hysteroscopic curettage.

Uterine artery embolization: a vascular surgery procedure? One vascular surgery group's experience

Vascular ◽  
2012 ◽  
Vol 20 (5) ◽  
pp. 268-272 ◽  
Author(s):  
Shelby Cooper ◽  
Luis M Oceguera ◽  
Stratton Danes
Keyword(s):  
Vascular Surgery ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Uterine Fibroids ◽  
Artery Embolization ◽  
Brief Training ◽  
The Mean ◽  
One Year ◽  
Proven Benefit

Uterine artery embolization (UAE) has been performed by interventional radiology since the 1990s for symptomatic uterine fibroids with considerable success. Endovascular-trained vascular surgeons possess the necessary skills to successfully perform this procedure after an adequate but brief training period. Fourteen successful UAE procedures were performed by two vascular surgeons over a one-year period. Indications for the procedures were bleeding (12/14 patients, 86%), pain/bloating/pressure (13/14 patients, 93%) and dyspareunia (2/14 patients, 14%). All patients were initially evaluated by a gynecologist and referred for this procedure. Complications were minor and limited. Clinical follow-up demonstrated near-complete to complete symptom resolution in all but one patient for a 93% short-term success rate. Follow-up ultrasound studies demonstrated a reduction in the uterine fibroid size in all patients three months or more postprocedure. The mean fibroid size reduction was 4.07–3.26 cm (20%), P < 0.005. UAE is a procedure of proven benefit, well-matched to many vascular surgeons’ skills and practice. Up to this point, few vascular surgeons have incorporated this endovascular procedure into their practices. This initial and somewhat limited study demonstrates one vascular surgery group's early success with this procedure.

Assessment of organ radiation dose associated with uterine artery embolization

2006 ◽  
Vol 47 (2) ◽  
pp. 179-185 ◽  
Author(s):  
O. Glomset ◽  
J. Hellesnes ◽  
N. Heimland ◽  
G. Hafsahl ◽  
H. J. Smith
Keyword(s):  
Statistical Analysis ◽  
Radiation Dose ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Skin Dose ◽  
Artery Embolization ◽  
System A ◽  
Significant Difference ◽  
The Mean ◽  
Peak Skin Dose

Purpose: To evaluate the radiation dose to the skin, uterus, and ovaries during uterine artery embolization. Material and Methods: Guided uterine artery embolization for leiomyomata and two types of X-ray equipment with different dose levels were utilized during fluoroscopy in 20 women (ages ranging from 32 to 52 years, body weights from 55 to 68 kg). The first 13 women were treated using a non-pulsed system A, with 3.3 mm Al filtering and, for simplicity, a fixed peak voltage 80 kV. During treatment of the other 7 women, a pulsed system B with 5.4 mm Al filtering and an identical fixed voltage was used. The dose area product (DAP) was recorded. The vaginal dose of the first 13 patients and the peak skin dose of all patients were measured with thermoluminescent dosimeters (TLDs). TLDs were placed in the posterior vaginal fornix and on the skin at the beam entrance site. The uterine and ovarian doses were estimated based on the measured skin doses, normalized depth dose, and organ depth values. The effective dose (Deff) was estimated based on the observed DAP values. The measured vaginal doses and the corresponding estimated uterine doses were compared statistically, as were the DAP values from systems A and B. Results: For system A, the mean fluoroscopic time was 20.9 min (range 12.7–31.1), and for system B 35.9 min (range 16.4–55.4). The mean numbers of angiographic exposures for systems A and B were 82 (range 30–164) and 37 (range 20–72), respectively. The mean peak skin dose for system A was 601.5 mGy (range 279–1030) and for system B 453 mGy (range 257–875). The mean DAP for system A was 88.6 Gy·cm2 (range 41.4–161.0) and for system B 52.5 Gy·cm2 (range 20.1–107.9). Statistical analysis showed a significant difference between the DAP values, the DAP for system B being the lower one. The mean estimated effective doses from systems A and B were 32 mSv (range 15.1–58.4) and 22 mSv (range 9–46), respectively. The mean estimated maximum uterine and ovarian doses using system A were 81 mGy (range 30–247) and 85 mGy (range 24–207), respectively; when using system B, the respective doses were 101 mGy (range 45–182) and 105 mGy (range 31–246). The measured vaginal doses had a mean value of 52.5 mGy (range 12–124). Statistical analysis revealed a significant difference between the estimated uterine doses and the measured vaginal doses. Conclusion: A significant difference was found between the estimated uterine doses and the corresponding measured vaginal doses. This has to be kept in mind when using vaginal doses as a substitute for the uterine dose. There was also a significant difference between the DAP values from systems A and B. System B, with pulsed fluoroscopy and greater filtration, gave the lower exposure. The maximum skin dose indicates that skin injuries are unlikely to occur. The ovarian doses are also below the threshold for temporary or permanent sterility. The stochastic risk for radiation-induced cancer and genetic injury to the patient's future children is not considered as substantial.

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