Selective Uterine Artery Embolization Research Articles

Embolization of bleeding residual uterine vascular malformations in patients with treated gestational trophoblastic tumors.

To retrospectively evaluate embolotherapy of bleeding residual uterine vascular malformations in patients with gestational trophoblastic tumors. Fourteen patients were treated over the past 20 years. Embolizations were performed with a common femoral artery approach. Duplex ultrasonography was performed before and after embolization to document the uterine vascularity. The technique and materials used for each embolization, control of hemorrhage, need for repeat embolization, complications, and outcome of subsequent pregnancies were assessed. Hemorrhage was controlled in 11 of the 14 patients; two patients required hysterectomy and one required uterine artery ligation for failure to control hemorrhage after initial embolization. Six patients required repeat embolization for recurrence of bleeding. Therapeutic benefit and success were associated with the ability to selectively embolize the uterine artery and to achieve a greater than 80% reduction in vascular malformation size. Pulsatility indexes of the uterine arteries and endometrial encroachment were not predictive of recurrent hemorrhage. Two patients delivered a total of three full-term infants, one patient experienced a miscarriage, and another experienced a termination of pregnancy following embolotherapy. Pain requiring opiate analgesia was a frequent complication of treatment. Selective uterine artery embolization is a safe and effective treatment for severe bleeding from residual uterine vascular malformations in patients with treated gestational trophoblastic tumors.

Selective uterine artery embolization in the management of uterine myomas.

Selective uterine artery embolization in the management of uterine myomas.

Is selective embolization of uterine arteries a safe alternative to hysterectomy in patients with postpartum hemorrhage?

The purpose of this study was to evaluate the efficacy and safety of selective arterial embolization to control severe postpartum hemorrhage. Twenty-five women with intractable postpartum hemorrhage underwent uterine embolization in our institution during a 6-year period. Angiography revealed arterial extravasation in 13 patients (52%). Sixty-nine arteries were embolized. External bleeding resolved immediately or was markedly decreased in 24 women. In one patient, embolization failed to control the bleeding, and surgical treatment was required. No major complication of embolization therapy was observed. Ten women were followed up for an average of 2 years. Menstruation resumed in all patients, and one woman became pregnant. Embolization of acute postpartum hemorrhage is a safe and effective alternative to hysterectomy.

Successful Embolization of Collaterals from the Ovarian Artery during Uterine Artery Embolization for Fibroids: A Case Report

UTERINE artery embolization (UAE) (also known as uterine fibroid embolization) as a definitive treatment for symptomatic uterine leiomyomata was first reported in 1995 ( 1 Ravina JH Herbreteau D Ciraru-Vigneron N et al. Arterial embolisation to treat uterine myomata. Lancet. 1995; 346: 671-672 Abstract PubMed Google Scholar ). While this and subsequent reports have shown great promise for the technique, clinical failure has been seen in as many as 20% of patients ( 2 Ravina JH Bouret JM Ciraru-Vigneron N et al. Recourse to particular arterial embolization in the treatment of some uterine leiomyoma. Bull Acad Natl Med. 1997; 181: 233-243 PubMed Google Scholar , 3 Goodwin SC Vedantham S McLucas B et al. Preliminary experience with uterine artery embolization for uterine fibroids. JVIR. 1997; 8: 517-526 Abstract Full Text PDF Scopus (326) Google Scholar , 4 Worthington-Kirsch RL Popky GL Hutchins Jr, FL Uterine arterial embolization for the management of leiomyomas: quality-of-life assessment and clinical response. Radiology. 1998; 208: 625-629 PubMed Google Scholar , 5 Spies JB Scialli AR Jha RC et al. Initial results from uterine fibroid embolization for symptomatic leiomyomata. JVIR. 1999; 10: 1149-1157 Abstract Full Text PDF Scopus (259) Google Scholar , 6 Goodwin SC McLucas B Lee M et al. Uterine artery embolization for the treatment of uterine leiomyomata midterm results. JVIR. 1999; 10: 1159-1165 Abstract Full Text PDF Scopus (407) Google Scholar , 7 Hutchins Jr, FL Worthington-Kirsch R Berkowitz RP Selective uterine artery embolization as primary treatment for symptomatic leiomyomata uteri. J Am Assoc Gynecol Laparosc. 1999; 6: 279-284 Abstract Full Text PDF PubMed Scopus (237) Google Scholar ). Among that group have been women undergoing unilateral embolization or having arterial supply to their fibroids from sources other than the uterine artery ( 3 Goodwin SC Vedantham S McLucas B et al. Preliminary experience with uterine artery embolization for uterine fibroids. JVIR. 1997; 8: 517-526 Abstract Full Text PDF Scopus (326) Google Scholar , 7 Hutchins Jr, FL Worthington-Kirsch R Berkowitz RP Selective uterine artery embolization as primary treatment for symptomatic leiomyomata uteri. J Am Assoc Gynecol Laparosc. 1999; 6: 279-284 Abstract Full Text PDF PubMed Scopus (237) Google Scholar , 8 Nikolic B Spies JB Abbara S Goodwin S Ovarian artery supply of uterine fibroids as a cause of treatment failure after uterine artery embolization: a case report. JVIR. 1999; 10: 1167-1170 Abstract Full Text PDF Scopus (103) Google Scholar ). This report describes a patient in whom the right ovarian artery provided the dominant arterial supply to a uterine fibroid. These collateral branches were selectively embolized via the ovarian artery with use of a microcatheter technique, giving satisfactory clinical and anatomic results.

Selective uterine artery embolization as primary treatment for symptomatic leiomyomata uteri

To analyze initial experience with uterine artery embolization for treatment of symptomatic leiomyomata. Prospective, longitudinal study (Canadian Task Force classification II-2). Private practice, university-affiliated hospital. Three hundred five women (age 26-52 yrs). Uterine artery embolization, performed over 2 years by a single radiologist working in collaboration with a single gynecology practice. Embolization was technically successful in 96% of patients. No major complications occurred. Average reduction in uterine volume was 48%. Control of menorrhagia was reported by 86% of patients at 3 months, 85% at 6 months, and 92% at 12 months after the procedure. Bulk symptoms were satisfactorily controlled in 64% of patients at 3 months, 77% at 6 months, and 92% at 12 months. Six women subsequently underwent hysterectomy and five had myomectomy. Uterine artery embolization appears to be a highly effective treatment for symptomatic uterine leiomyomata. Its impact on fertility and pregnancy remain to be investigated fully. (J Am Assoc Gynecol Laparosc 6(3):279-284, 1999)

Selective uterine artery embolization in the treatment of cervical pregnancy: two case reports

Two patients presenting a cervical trophoblastic implantation were treated with selective uterine artery embolization associated with dilatation and curettage. This interventional radiological maneuver helped greatly in the management of the bleeding caused by the ectopic pregnancies.