Feasibility of a three-dimensional rotational angiography road map for individualized guidance of uterine artery catheterization

Wei Li ,X.s Deng ,G Li ,Y James Kang

doi:10.31083/j.ceog.2020.05.5416

Abstract

Objectives: This study aimed to compare the feasibility and advantages of a three-dimensional rotational angiography (3DRA) road map for individualized guidance of uterine artery (UA) catheterization with those of a conventional two-dimensional (2D) road map. Materials and Methods: Twenty patients were randomly assigned to the 3DRA and 2D groups for UA catheterization and embolization for symptomatic uterine fibroid, postpartum haemorrhage, incision pregnancy, adenomyosis, and cervical cancer in the past 2 years at our hospital. Demographic data such as patient age, abdominal perimeter, and uterine diseases were recorded. Procedure time, fluoroscopy time, contrast medium volume, and patient radiation dose were also recorded. There was no difference between the two groups in terms of demographic data. Results: All 20 patients were successfully catheterized with the guidance of the 3DRA or 2D road map. Patients with the 3DRA road map had shorter total procedure time, catheterization time, fluoroscopy time, and smaller contrast medium volume and irradiation. Conclusions: the 3DRA road map is feasible and useful for the individualized guidance of UA catheterization and preferable to the conventional 2D road map.

Highlights

Uterine artery (UA) embolization (UAE) is an effective, minimally invasive, interventional procedure for the treatment of symptomatic leiomyomas, postpartum haemorrhage (PPH), uterine vascular malformations, pregnancy incisions, adenomyosis, and cervical cancer with bleeding
This process is timeconsuming because, sometimes, it is difficult to visualize UA origins under conventional two-dimensional (2D) angiography owing to unappreciated vessels overlapping or foreshortening, resulting in an increase in the procedure time, contrast agent dose, and radiation dose
In the 2D group, a mean of 2.8 exposures was performed to obtain the best view of the origin of the UA for the subsequent super-selective catheterization

Summary

Introduction

Uterine artery (UA) embolization (UAE) is an effective, minimally invasive, interventional procedure for the treatment of symptomatic leiomyomas, postpartum haemorrhage (PPH), uterine vascular malformations, pregnancy incisions, adenomyosis, and cervical cancer with bleeding. Catheterization of the UA is a prerequisite for a subsequent embolization treatment. This process is timeconsuming because, sometimes, it is difficult to visualize UA origins under conventional two-dimensional (2D) angiography owing to unappreciated vessels overlapping or foreshortening, resulting in an increase in the procedure time, contrast agent dose, and radiation dose. Three-dimensional (3D) road maps and navigation techniques have shown their usefulness and potential capacity for time and dose reduction in interventional catheterdirected procedures for intracranial arteries [3, 4]. We attempted to adopt this technique to guide the catheterization of the UA and compare its feasibility and advantages to those of conventional 2D road maps

Objectives

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Discussion

Conclusion