1887
Volume 2003, Issue 1
  • ISSN: 0253-8253
  • EISSN: 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.

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2003-06-01
2024-03-29
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References

  1. Vollenhoven BJ, Lawrence AS, Healy DL. Uterine fibroids: A clinical review. Br. J. Obstet. Gynaecol. 1990; 97::285289.
    [Google Scholar]
  2. Healy DL, Vollenhoven BJ. The role of GnRH agonists in the treatment of uterine fibroids. Br. J. Obstet. Gynecol. 1992; 99::2326.
    [Google Scholar]
  3. Broder MS, Kanouse DE, Mittman BS, Bernstein SJ. The appropriateness of recommendations for hysterectomy. Obstet. Gynecol. 2000; 95::199205.
    [Google Scholar]
  4. Reidy JF, Bradley EA. Uterine artery embolization for fibroid disease. Cardiovasc. lntervent. Radiol. 1998; 2::357360.
    [Google Scholar]
  5. Greenberg MD, Kazamel Tl. Medical and socioeconomic impact of uterine fibroids. Obstet. Gynecol. Clin North Am. 1995; 22::625636.
    [Google Scholar]
  6. Smith SJ:. Uterine fibroid embolization. Am. Family Phys. 2000; 61::36013607.
    [Google Scholar]
  7. Andersen PE, Lund N, Justesen P, Munk T, Elle B, Floridon C. Uterine artery embolization of symptomatic uterine fibroids. Acta Radiol. 2001; 42::234238.
    [Google Scholar]
  8. Burn P, McCall J, Chinn R, Healy J. Embolization of.uterine fibroids. Brit. J. Radiol. 1999; 72::159161.
    [Google Scholar]
  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::428431.
    [Google Scholar]
  10. Hutchins FL, Worthington-Kirsch R. Embolotherapy for myoma-induced menorrhagia. Obstet. Gynec. Clin. North. Am. 2000; 27::397405.
    [Google Scholar]
  11. Athanasoulis CA, Waltman AC, Barnes AB, et al., Angiographic control of pelvic bleeding from treated carcinoma of the cervix. Gynecol. Oncol. 1976; 4::144150.
    [Google Scholar]
  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::597601.
    [Google Scholar]
  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::10281032.
    [Google Scholar]
  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::4549.
    [Google Scholar]
  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::671672.
    [Google Scholar]
  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::517526.
    [Google Scholar]
  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::235240.
    [Google Scholar]
  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::11491157.
    [Google Scholar]
  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::279284.
    [Google Scholar]
  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::12671272.
    [Google Scholar]
  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::4749.
    [Google Scholar]
  22. Siskin GP, Englander M, Stainken BF, Ahn BF, Dowling K, Dolen EG:. Embolic agents used for uterine fibroid embolization. AJR. 2000; 175::767773.
    [Google Scholar]
  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::625629.
    [Google Scholar]
  24. Vashisht A, Studd J, Carey A, Burn P. Fatal septicemia after fibroid embolisation. Lancet. 1999; 354::307308.
    [Google Scholar]
  25. McLucas B, Goodwin SC, Adler L, Reed R. Fatal septicaemia after fibroid embolisation /letter/. Lancet. 1999; 354::1730.
    [Google Scholar]
  26. Robson S, Wilson K, Munday D, Sebben R. Pelvic sepsis complicating embolization of uterine fibroid. Aust. NZJ. Obstet. Gynaecol. 1999; 39::516517.
    [Google Scholar]
  27. Hill DJ. Complications of hysterectomy. Baillieres Clin. Obstet. Gynecol. 1997; 11::181195.
    [Google Scholar]
  28. Wingo PA, Huezo CM, Rubin GL, Ory HW, Peterson HB. The mortality risk associated with hysterectomy. Am. J. Obstet. Gynecol. 1985; 152::803808.
    [Google Scholar]
  29. Scialli AR. Is hysterectomy obsolete? Am. Family Phys. 2000; 61::35593560.
    [Google Scholar]
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  • Article Type: Research Article
Keyword(s): embolisation-therapeuticfibromahemorrhageinterventional proceduresleiomyomaneoplasms and uterus
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