1887
Volume 2003, Issue 1
  • ISSN: 0253-8253
  • E-ISSN: 2227-0426

Abstract

Uterine artery embolisation has been introduced recently as an alternative treatment for fibroids. The purpose of this study was to evaluate the initial results of uterine artery embolisation in the treatment of symptomatic muterine leiomyomata in HMC and review the data from the literature.

On the basis of clinical and ultrasonographic examinations, four women aged between 35 to 44 years with severe fibroid-related menorrhagia were referred for uterine artery embolisation. In allfour cases bilateral embolisation of the uterine arteries was carried out using particles of polyvinyl alcohol (Ivalon, 500-750jum) under local anaesthesia and fluoroscopy I digital subtraction angiography control. Complete occlusion of the arteries supplying the fibroids was achieved resulting in restoration of normal menstrual bleeding. Three patients did not develop any complications, except short post-embolisation discomfort lasting only a few hours. In one case with large fibroids, a post-embolisation syndrome (abdominal pain, sweating, vomiting and increased blood pressure) lasting 48 hours was observed. All the patients expressed satisfaction with the treatment.

Data from the literature indicate that uterine artery embolisation has gained wide acceptance in the treatment of symptomatic uterine fibroids, particularly in patients wishing to avoid total hysterectomy or blood transfusion, although hysteroscopic resection, myolysis and laparoscopic myomectomy remain alternative methods of treatment.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2003.1.15
2003-06-01
2019-08-18
Loading full text...

Full text loading...

References

  1. 1. Vollenhoven   BJ., , Lawrence   AS., , Healy   DL. . Uterine fibroids: A clinical review. . Br. J. Obstet. Gynaecol.   1990; ;97: : 285– 289 .
    [Google Scholar]
  2. 2. Healy   DL., , Vollenhoven   BJ. . The role of GnRH agonists in the treatment of uterine fibroids. . Br. J. Obstet. Gynecol.   1992; ;99: : 23– 26 .
    [Google Scholar]
  3. 3. Broder   MS., , Kanouse   DE., , Mittman   BS., , Bernstein   SJ. . The appropriateness of recommendations for hysterectomy. . Obstet. Gynecol.   2000; ;95: : 199– 205 .
    [Google Scholar]
  4. 4. Reidy   JF., , Bradley   EA. . Uterine artery embolization for fibroid disease. . Cardiovasc. lntervent. Radiol.   1998; ;2: : 357– 360 .
    [Google Scholar]
  5. 5. Greenberg   MD., , Kazamel   Tl. . Medical and socioeconomic impact of uterine fibroids. . Obstet. Gynecol. Clin North Am.   1995; ;22: : 625– 636 .
    [Google Scholar]
  6. 6. Smith   SJ:. . Uterine fibroid embolization. . Am. Family Phys.   2000; ;61: : 3601– 3607 .
    [Google Scholar]
  7. 7. Andersen   PE., , Lund   N., , Justesen   P., , Munk   T., , Elle   B., , Floridon   C. . Uterine artery embolization of symptomatic uterine fibroids. . Acta Radiol.   2001; ;42: : 234– 238 .
    [Google Scholar]
  8. 8. Burn   P., , McCall   J., , Chinn   R., , Healy   J. . Embolization of.uterine fibroids. . Brit. J. Radiol.   1999; ;72: : 159– 161 .
    [Google Scholar]
  9. 9. Pelage   JP., , Le Dref   O., , Soyer   Ph., , Kardache   M., , Dahan., , Abitbol   M., , Merland   JJ., , Ravina   JH., , Rymer   R. . Fibroid-related menorrhagia: Treatment with superselective embolization of the uterine arteries and midterm follow-up. . Radiology . 2000; ;215: : 428– 431 .
    [Google Scholar]
  10. 10. Hutchins   FL., , Worthington-Kirsch   R. . Embolotherapy for myoma-induced menorrhagia. . Obstet. Gynec. Clin. North. Am.   2000; ;27: : 397– 405 .
    [Google Scholar]
  11. 11. Athanasoulis   CA., , Waltman   AC., , Barnes   AB. , et al. , Angiographic control of pelvic bleeding from treated carcinoma of the cervix. . Gynecol. Oncol.   1976; ;4: : 144– 150 .
    [Google Scholar]
  12. 12. Bree   RL., , Goldstein   HM., , Wallace   S. . Transcatheter embolization of the internal iliac artery in the management of neoplasms of the pelvis. . Surg.Gynecol. Obstet . 1976; ;143: : 597– 601 .
    [Google Scholar]
  13. 13. Miller   FJ., , Mortel   R., , Mann   WJ. , et al. , Selective arterial embolization for control of hemorrhage in pelvic malignancy: Femoral and brachial catheter approaches. . AJR . 1976; ;126: : 1028– 1032 .
    [Google Scholar]
  14. 14. Ravina   JH., , Bouret   JM., , Fried   D. , et al. , Value of preoperative embolization of uterine fibroma: Report of multicenter series of 31 cases. . Contracept. Fertil. Sex.   1995; ;23: : 45– 49 .
    [Google Scholar]
  15. 15. Ravina   JH., , Herbretau   D., , Ciraru-Vigneron   N., , Bouret   JM., , Houdart   E., , Aymard   A., , Merland   JJ:. . Arterial embolization to treat uterine myomata. . Lancet . 1995; ;346: : 671– 672 .
    [Google Scholar]
  16. 16. Goodwin   SC., , Vedantham   S., , McLucas   B., , Forno   AE., , Perella   R. . Uterine artery embolization for uterine fibroids: Results of pilot study. . J. Vase. Intervent. Radiol.   1997; ;8: : 517– 526 .
    [Google Scholar]
  17. 17. Bradley   EA., , Reidy   JF., , Forman   RG., , Jarosz   J., , Braude   PR. . Transcatheter uterine embolization to treat large uterine fibroids. . Brit. J. Obstet. Gynec.   1998; ;105: : 235– 240 .
    [Google Scholar]
  18. 18. Spies   JB., , Scialli   AR., , Jha   RC., , Imaoka   I., , Ascher   SM., , Fraga   VM. , et al. , Initial results from uterine fibroid embolization for symptomatic leiomyomata. . J. Vase. Interv. Radiol.   1999; ;10: : 1149– 1157 .
    [Google Scholar]
  19. 19. Hutchins   FL., , Worthington-Kirsch   RL., , Berkowitz   RP. . Selective uterine artery embolization as primary treatment for symptomatic leiomyomata uteri: a review of 305 consecutive cases. . J. Am. Assoc. Gynecol. Laparosc.   1999; ;6: : 279– 284 .
    [Google Scholar]
  20. 20. Brunereau   L., , Herbreteau   D., , Gallas   S., , Cottier   JPh., , Lebrun   JL., , Tranquart   F., , Faichier   F., , Body   G., , Rouleau   Ph:. . Uterine artery embolization in the primary treatment of uterine leiomyomas: Technical features and prospective follow-up with clinical and sonographic examinations in 58 patients. . AJR . 2000; ;175: : 1267– 1272 .
    [Google Scholar]
  21. 21. Szmigielski   W., , Dahniya   MH., , Hanna   RM., , Hatab   M., , Reddy   CK. . Life threatening post-nephrolithotomy hemorrhage resulting in cessation of kidney function, treated by transcatheter arterial embolization with subsequent restoration of excretory function. . Acta Radiol.   1991; ;32: : 47– 49 .
    [Google Scholar]
  22. 22. Siskin   GP., , Englander   M., , Stainken   BF., , Ahn   BF., , Dowling   K., , Dolen   EG:. . Embolic agents used for uterine fibroid embolization. . AJR . 2000; ;175: : 767– 773 .
    [Google Scholar]
  23. 23. Worthington-Kirsch   RL., , Popky   GL., , Hutchins   FL Jr. . Uterine arterial embolization for the management of leiomyomas: Quality-of life assessment and clinical response. . Radiology . 1998; ;208: : 625– 629 .
    [Google Scholar]
  24. 24. Vashisht   A., , Studd   J., , Carey   A., , Burn   P. . Fatal septicemia after fibroid embolisation. . Lancet . 1999; ;354: : 307– 308 .
    [Google Scholar]
  25. 25. McLucas   B., , Goodwin   SC., , Adler   L., , Reed   R. . Fatal septicaemia after fibroid embolisation /letter/. . Lancet . 1999; ;354: : 1730 .
    [Google Scholar]
  26. 26. Robson   S., , Wilson   K., , Munday   D., , Sebben   R. . Pelvic sepsis complicating embolization of uterine fibroid. . Aust. NZJ. Obstet. Gynaecol.   1999; ;39: : 516– 517 .
    [Google Scholar]
  27. 27. Hill   DJ. . Complications of hysterectomy. . Baillieres Clin. Obstet. Gynecol.   1997; ;11: : 181– 195 .
    [Google Scholar]
  28. 28. Wingo   PA., , Huezo   CM., , Rubin   GL., , Ory   HW., , Peterson   HB. . The mortality risk associated with hysterectomy. . Am. J. Obstet. Gynecol.   1985; ;152: : 803– 808 .
    [Google Scholar]
  29. 29. Scialli   AR. . Is hysterectomy obsolete?.   Am. Family Phys . 2000; ;61: : 3559– 3560 .
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/qmj.2003.1.15
Loading
  • Article Type: Research Article
Keyword(s): embolisation-therapeutic , fibroma , hemorrhage , interventional procedures , leiomyoma , neoplasms and uterus
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error