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Uterine artery embolization: is it reliable for myoma treatment?

Yıl 2017, Cilt: 3 Sayı: 2, 127 - 134, 04.07.2017
https://doi.org/10.18621/eurj.293133

Öz

Objective. We aimed to share the long-term technical and clinical success results, complications and radiologic follow-up findings in our myoma cases treated with uterine artery embolization (UAE) ) and to make a contribution to the literature data on this subject. Method. The study was retrospective and the results of 70 patients who underwent UAE for myoma treatment at our institute between January 2012 and January 2015 were analyzed. Results. The age range was 22 to 46 years and the mean age 34 years. The postprocedural follow-up duration was 6 to 24 months and the mean follow-up duration was 14 months. The technical success rate was 100% and the clinical success rate was 84.7%. On postprocedural follow-up, fibroid passage was seen in 2 patients (2.85%), severe hypermenorrhea in 4 (5.7%) and postembolization syndrome in 6 (8.5%). Our myoma recurrence rate was 11.36% (n=5). The UAE procedure did not need to be repeated in any of the patients. Conclusions. UAE is a reliable alternative to hysterectomy and myomectomy. We believe that UAE should be preferred in patients who are recommended hysterectomy or are predicted to potentially need hysterectomy during myomectomy. 

Kaynakça

  • [1] Barnard EP, Abdelmagied AM,Vaughan LE, Weaver AL, Laughlin-Tommaso SK, Hesley GK. Periprocedural outcomes comparing fibroid embolization and focused ultrasound: a randomized controlled trial and comprehensive cohort analysis. Am J Obstet Gynecol 2017 Jan 4. pii: S0002-9378(16)46488-4. doi: 10.1016/j.ajog.2016.12.177.
  • [2] Bratby MJ, Belli AM. Radiological treatment of symptomatic uterine fibroids. Best Pract Res Clin Obstet Gynaecol 2008;22:717-34.
  • [3] Dinc H. [Uterine artery embolization]. Turkiye Klinikleri J Radiol-Special Topics 2012;5:202-10. [Article in Turkish]
  • [4] Lohle PN, Voogt MJ, De Vries J,Smeets AJ, Vervest HA, Lampmann LE, et al. Long-term outcome of uterine artery embolization for symptomatic uterine leiomyomas. J Vasc Interv Radiol 2008;19:319-26.
  • [5] Torre A, Fauconnier A, Kahn V, Limot O, Bussierres L, Pelage JP .Fertility after uterine artery embolization for symptomatic multiple fibroids with no other infertility factors. Eur Radiol 2016 Dec 13.
  • [6] Pelage JP, Cazejust J, Pluot E, Le Dref O, Laurent A, Spies JB, et al. Uterine fibroid vascularization and clinical relevance to uterine fibroid embolization. Radiographics 2005;25:99-117.
  • [7] Dogan N, Karatas S, Erdemir M, Kurt O, Baykan D. [Uterine artery embolization for myomas treatment: early results]. Uludag Univ Tip Fakultesi Dergisi 2013;39;147-51. [Article in Turkish]
  • [8] Voogt MJ, Arntz MJ, Lohle PNM, Mali WPM, Lampmann LEH. Uterine fibroid embolisation for symptomatic uterine fibroids: a survey of clinical practice in Europe. Cardiovasc Intervent Radiol 2011;34:765-73.
  • [9] Boosz AS, Reimer P, Matzko M, Romer T, Muller A. The conservative and interventional treatment of fibroids. Dtsch Arztebl Int 2014;111:877-83.
  • [10] Tomislav S, Josip M, Liana CS, Marko V, Marko J, Ante R, et al. Uterine artery embolization as nonsurgical treatment of uterine myomas. ISRN Obstet Gynecol 2011;23:489281.
  • [11] Duhan N. Current and emerging treatments for uterine myoma - an update. Int J Womens Health 2011;3:231-41.
  • [12] Parker WH. Uterine myomas: management. Fertil Steril 2007;88:255-71.
  • [13] Ravina JH, Herbreteau D, Ciraru-Vigneron N, Bouret JM, Houdart E, Aymard A, et al. Arterial embolisation to treat uterine myomata. Lancet 1995;346:671-2.
  • [14] Mara M, Horak P, Kubinova K, Dundr P, Belsan T, Kuzel D. Hysteroscopy after uterine fibroid embolization: evaluation of intrauterine findings in 127 patients. J Obstet Gynaecol Res 2012;38:823-31.
  • [15] Liu R, Dai E, Chen C, Liu P. [Application of in vivo pelvis and abdominal-pelvic arterial network digital three-dimensional model for uterine artery embolization in surgical approach planning]. Zhonghua Fu Chan Ke Za Zhi 2014;49:89-93. [Article in Chinese]
  • [16] Stampfl U, Radeleff B, Sommer C, Stampfl S, Dahlke A, Bellemann N, et al. Midterm results of uterine artery embolization using narrow-size calibrated embozene microspheres. Cardiovasc Intervent Radiol 2011;34:295-305.
  • [17] Ustunsoz B, Ugurel MS, Bozlar U, Duru NK, Ustunsoz A. Is uterine artery embolization prior to myomectomy for giant fibroids helpful? Diagn Interv Radiol 2007;13:210-12.
  • [18] Greenwood LH, Glickman MG, Schwartz PE Morse SS, Denny DF. Obstetric and nonmalignant gynecologic bleeding: treatment with angiographic embolization. Radiology 1987;164:155-9.
  • [19] Abbas FM, Currie JL, Mitchell S, Osterman F, Rosenshein NB, Horowitz IR. Selective vascular embolization in benign gynecologic conditions. J Reprod Med 1994;39:492-6.
  • [20] Stringer NH, Grant T, Park J, Oldham L. Ovarian failure after uterine artery embolization for treatment of myomas. J Am Assoc Gynecol Laparoscopist 2000;7:395-400.
  • [21] Toor SS, Jaberi A, Macdonald DB, McInnes MD, Schweitzer ME, Rasuli P. 2012. Complication rates and effectiveness of uterine artery embolization in the treatment of symptomatic leiomyomas: a systematic review and meta-analysis. AJR Am J Roentgenol 2012;199:1153-63.
  • [22] Suzuki S, Tanigawa N, Kariya S, Komemushi A, Kojima H, Tokuda T, et al. Posterior reversible encephalopathy syndrome occurring after uterine artery embolization for uterine myoma. Cardiovasc Intervent Radiol 2011;34:157-60.
  • [23] Gupta JK, Sinha A, Lumsden MA, Hickey M. Uterine artery embolization for symptomatic uterine fibroids. Cochrane Database Syst Rev 2014;12:CD005073.
  • [24] Bakri YN, Linjawi T. Angiographic embolization for control of pelvic genital tract hemorrhage. Report of 14 cases. Acta Obstet Gynecol Scand 1992;71:17-21.
  • [25] Usadi RS, Marshburn PB. The impact of uterine artery embolization on fertility and pregnancy outcome. Curr Opin Obstet Gynecol 2007;19:279-83.
Yıl 2017, Cilt: 3 Sayı: 2, 127 - 134, 04.07.2017
https://doi.org/10.18621/eurj.293133

Öz

Kaynakça

  • [1] Barnard EP, Abdelmagied AM,Vaughan LE, Weaver AL, Laughlin-Tommaso SK, Hesley GK. Periprocedural outcomes comparing fibroid embolization and focused ultrasound: a randomized controlled trial and comprehensive cohort analysis. Am J Obstet Gynecol 2017 Jan 4. pii: S0002-9378(16)46488-4. doi: 10.1016/j.ajog.2016.12.177.
  • [2] Bratby MJ, Belli AM. Radiological treatment of symptomatic uterine fibroids. Best Pract Res Clin Obstet Gynaecol 2008;22:717-34.
  • [3] Dinc H. [Uterine artery embolization]. Turkiye Klinikleri J Radiol-Special Topics 2012;5:202-10. [Article in Turkish]
  • [4] Lohle PN, Voogt MJ, De Vries J,Smeets AJ, Vervest HA, Lampmann LE, et al. Long-term outcome of uterine artery embolization for symptomatic uterine leiomyomas. J Vasc Interv Radiol 2008;19:319-26.
  • [5] Torre A, Fauconnier A, Kahn V, Limot O, Bussierres L, Pelage JP .Fertility after uterine artery embolization for symptomatic multiple fibroids with no other infertility factors. Eur Radiol 2016 Dec 13.
  • [6] Pelage JP, Cazejust J, Pluot E, Le Dref O, Laurent A, Spies JB, et al. Uterine fibroid vascularization and clinical relevance to uterine fibroid embolization. Radiographics 2005;25:99-117.
  • [7] Dogan N, Karatas S, Erdemir M, Kurt O, Baykan D. [Uterine artery embolization for myomas treatment: early results]. Uludag Univ Tip Fakultesi Dergisi 2013;39;147-51. [Article in Turkish]
  • [8] Voogt MJ, Arntz MJ, Lohle PNM, Mali WPM, Lampmann LEH. Uterine fibroid embolisation for symptomatic uterine fibroids: a survey of clinical practice in Europe. Cardiovasc Intervent Radiol 2011;34:765-73.
  • [9] Boosz AS, Reimer P, Matzko M, Romer T, Muller A. The conservative and interventional treatment of fibroids. Dtsch Arztebl Int 2014;111:877-83.
  • [10] Tomislav S, Josip M, Liana CS, Marko V, Marko J, Ante R, et al. Uterine artery embolization as nonsurgical treatment of uterine myomas. ISRN Obstet Gynecol 2011;23:489281.
  • [11] Duhan N. Current and emerging treatments for uterine myoma - an update. Int J Womens Health 2011;3:231-41.
  • [12] Parker WH. Uterine myomas: management. Fertil Steril 2007;88:255-71.
  • [13] Ravina JH, Herbreteau D, Ciraru-Vigneron N, Bouret JM, Houdart E, Aymard A, et al. Arterial embolisation to treat uterine myomata. Lancet 1995;346:671-2.
  • [14] Mara M, Horak P, Kubinova K, Dundr P, Belsan T, Kuzel D. Hysteroscopy after uterine fibroid embolization: evaluation of intrauterine findings in 127 patients. J Obstet Gynaecol Res 2012;38:823-31.
  • [15] Liu R, Dai E, Chen C, Liu P. [Application of in vivo pelvis and abdominal-pelvic arterial network digital three-dimensional model for uterine artery embolization in surgical approach planning]. Zhonghua Fu Chan Ke Za Zhi 2014;49:89-93. [Article in Chinese]
  • [16] Stampfl U, Radeleff B, Sommer C, Stampfl S, Dahlke A, Bellemann N, et al. Midterm results of uterine artery embolization using narrow-size calibrated embozene microspheres. Cardiovasc Intervent Radiol 2011;34:295-305.
  • [17] Ustunsoz B, Ugurel MS, Bozlar U, Duru NK, Ustunsoz A. Is uterine artery embolization prior to myomectomy for giant fibroids helpful? Diagn Interv Radiol 2007;13:210-12.
  • [18] Greenwood LH, Glickman MG, Schwartz PE Morse SS, Denny DF. Obstetric and nonmalignant gynecologic bleeding: treatment with angiographic embolization. Radiology 1987;164:155-9.
  • [19] Abbas FM, Currie JL, Mitchell S, Osterman F, Rosenshein NB, Horowitz IR. Selective vascular embolization in benign gynecologic conditions. J Reprod Med 1994;39:492-6.
  • [20] Stringer NH, Grant T, Park J, Oldham L. Ovarian failure after uterine artery embolization for treatment of myomas. J Am Assoc Gynecol Laparoscopist 2000;7:395-400.
  • [21] Toor SS, Jaberi A, Macdonald DB, McInnes MD, Schweitzer ME, Rasuli P. 2012. Complication rates and effectiveness of uterine artery embolization in the treatment of symptomatic leiomyomas: a systematic review and meta-analysis. AJR Am J Roentgenol 2012;199:1153-63.
  • [22] Suzuki S, Tanigawa N, Kariya S, Komemushi A, Kojima H, Tokuda T, et al. Posterior reversible encephalopathy syndrome occurring after uterine artery embolization for uterine myoma. Cardiovasc Intervent Radiol 2011;34:157-60.
  • [23] Gupta JK, Sinha A, Lumsden MA, Hickey M. Uterine artery embolization for symptomatic uterine fibroids. Cochrane Database Syst Rev 2014;12:CD005073.
  • [24] Bakri YN, Linjawi T. Angiographic embolization for control of pelvic genital tract hemorrhage. Report of 14 cases. Acta Obstet Gynecol Scand 1992;71:17-21.
  • [25] Usadi RS, Marshburn PB. The impact of uterine artery embolization on fertility and pregnancy outcome. Curr Opin Obstet Gynecol 2007;19:279-83.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Konular Sağlık Kurumları Yönetimi
Bölüm Original Article
Yazarlar

Nurullah Dogan

Omer Fatih Nas

Yayımlanma Tarihi 4 Temmuz 2017
Gönderilme Tarihi 18 Eylül 2016
Kabul Tarihi 15 Ocak 2017
Yayımlandığı Sayı Yıl 2017 Cilt: 3 Sayı: 2

Kaynak Göster

AMA Dogan N, Nas OF. Uterine artery embolization: is it reliable for myoma treatment?. Eur Res J. Temmuz 2017;3(2):127-134. doi:10.18621/eurj.293133

e-ISSN: 2149-3189 


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