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Semin intervent Radiol 2008; 25(4): 369-377
DOI: 10.1055/s-0028-1103001
© Thieme Medical Publishers

Uterine Artery Embolization for Treatment of Symptomatic Fibroids

Carin Gonsalves1
  • 1Division of Cardiovascular and Interventional Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
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Publication History

Publication Date:
15 December 2008 (online)

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ABSTRACT

Over the past decade, uterine artery embolization (UAE) has become a popular alternative treatment for women with symptomatic fibroids who desire uterine preservation and/or the avoidance of surgical intervention. In this article, the history of UAE, preprocedure patient evaluation and patient selection, procedure technique, and expected UAE outcomes are reviewed.

KEYWORDS

Uterine artery embolization - fibroids - tris-acryl microspheres - spherical PVA - acrylamido PVA microspheres

REFERENCES

  • 1 Murase E, Siegelman E S, Outwater E K et al.. Uterine leiomyomas: histopathologic features, MR imaging findings, differential diagnosis, and treatment.  Radiographics. 1999;  19 1179-1197
    PubMedSearch in Google Scholar
  • 2 Reidy J F, Bradley E A. Uterine artery embolization for fibroid disease.  Cardiovasc Intervent Radiol. 1998;  21 357-360
    CrossrefPubMedSearch in Google Scholar
  • 3 Spies J S, Pelage J P. Uterine artery embolization and gynecologic embolotherapy. Philadelphia; Lippincott Williams & Wilkins 2005: 3-18
    Search in Google Scholar
  • 4 Stewart E A. Treatment of uterine fibroids.  Lancet. 2001;  357 293-298
    CrossrefPubMedSearch in Google Scholar
  • 5 Andrews R T, Spies J B, Sacks D. Patient care and uterine artery embolization for leiomyomata.  J Vasc Interv Radiol. 2004;  15 115-120
    PubMedSearch in Google Scholar
  • 6 Ravina J H, Herbreteau D, Ciraru-Vigneron N et al.. Arterial embolization to treat uterine myomata.  Lancet. 1995;  346 671-672
    CrossrefPubMedSearch in Google Scholar
  • 7 Goodwin S C, Vedantham S, McLucas B et al.. Preliminary experience with uterine artery embolization for uterine fibroids.  J Vasc Interv Radiol. 1997;  8(4) 517-526
    CrossrefPubMedSearch in Google Scholar
  • 8 Goodwin S C, Bonilla S M, Sacks D et al.. Reporting standards for uterine artery embolization for the treatment of uterine leiomyomata.  J Vasc Interv Radiol. 2001;  12(9) 1011-1020
    CrossrefPubMedSearch in Google Scholar
  • 9 Pron G, Mocarski E, Bennett J et al.. Pregnancy after uterine artery embolization for leiomyomata: Ontario multicenter trial.  Obstet Gynecol. 2005;  105(1) 67-76
    PubMedSearch in Google Scholar
  • 10 McLucas B. Pregnancy following uterine fibroid embolization.  Int J Gynaecol Obstet. 2001;  74 1-7
    CrossrefPubMedSearch in Google Scholar
  • 11 Spielmann A L, Keogh C, Forster B B et al.. Comparison of MRI and sonography in the preliminary evaluation for fibroid embolization.  AJR Am J Roentgenol. 2006;  187 1499-1504
    CrossrefPubMedSearch in Google Scholar
  • 12 Siskin G P. Uterine fibroid embolization: successful patient selection is difficult, but makes all the difference. Endovascular Today. Available at: http://www.evtodayarchive.com/03_archive/1102/071.html Accessed March 15, 2008
    Search in Google Scholar
  • 13 Verma S K, Bergin D, Gonsalves C et al.. Submucosal fibroids becoming endocavitary following uterine artery embolization: risk assessment by MRI.  AJR Am J Roentgenol. 2008;  190 1220-1226
    CrossrefPubMedSearch in Google Scholar
  • 14 Zawin M, McCarthy S, Scoutt L M, Comite F. High-field MRI and US evaluation of the pelvis in women with leiomyomas.  Magn Reson Imaging. 1990;  8(4) 371-376
    PubMedSearch in Google Scholar
  • 15 Bazot M, Cortez A, Darai E et al.. Ultrasound compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology.  Hum Reprod. 2001;  16(11) 2427-2433
    PubMedSearch in Google Scholar
  • 16 Pelage J P, Jacob D, Fazel A et al.. Midterm results of uterine artery embolization for symptomatic adenomyosis: initial experience.  Radiology. 2005;  234 948-953
    CrossrefPubMedSearch in Google Scholar
  • 17 Parazzini F, Vercellini P, Panazza S et al.. Risk factors for adenomyosis.  Hum Reprod. 1997;  12(6) 1275-1279
    CrossrefPubMedSearch in Google Scholar
  • 18 Matalliotakis I M, Kourtis A I, Panidis D K. Adenomyosis.  Obstet Gynecol Clin North Am. 2003;  30(1) 63-82
    CrossrefPubMedSearch in Google Scholar
  • 19 Binkert C A, Andrews R T, Kaufman J A. Utility of nonselective abdominal aortography in demonstrating ovarian artery collaterals in patients undergoing uterine artery embolization for fibroids.  J Vasc Interv Radiol. 2001;  12 841-845
    CrossrefPubMedSearch in Google Scholar
  • 20 Pelage J P, Walker W J, Le Dref O. Re: utility of nonselective abdominal aortography in demonstrating ovarian artery collaterals in patients undergoing uterine artery embolization for fibroids.  J Vasc Interv Radiol. 2002;  13(6) 656
    PubMedSearch in Google Scholar
  • 21 Pelage J P, Laurant A, Wassef M et al.. Uterine artery embolization in sheep: comparison of acute effects with polyvinyl alcohol particles and calibrated microspheres.  Radiology. 2002;  224 436-445
    CrossrefPubMedSearch in Google Scholar
  • 22 Pelage J P, Le Dref O, Beregi J P et al.. Limited uterine artery embolization with tris-acryl gelatin microspheres for uterine fibroids.  J Vasc Interv Radiol. 2003;  14(1) 15-20
    PubMedSearch in Google Scholar
  • 23 Siskin G P, Beck A, Schuster M. Leiomyoma infarction after uterine artery embolization: a prospective randomized study comparing tris-acryl gelatin microspheres versus polyvinyl alcohol microspheres.  J Vasc Interv Radiol. 2003;  14 58-65
    PubMedSearch in Google Scholar
  • 24 Spies J B, Allison S, Flick P et al.. Spherical polyvinyl alcohol versus tris-acryl gelatin microspheres for uterine artery embolization for leiomyomas: results of a limited randomized comparative study.  J Vasc Interv Radiol. 2005;  16 1431-1437
    CrossrefPubMedSearch in Google Scholar
  • 25 Laurent A, Wassef M, Pelage J P et al.. In vitro and in vivo deformation of TGMS and PVA microsphere in relation with their arterial location.  J Vasc Interv Radiol. 2005;  16 S77
    PubMedSearch in Google Scholar
  • 26 Pelage J P, Lohle P, Kroencke T J et al.. Technical optimization of uterine fibroid embolization using polyvinyl alcohol microspheres.  J Vasc Interv Radiol. 2005;  16 568
    PubMedSearch in Google Scholar
  • 27 Siskin G P, Beck A, Schuster M et al.. Leiomyoma infarction after uterine artery embolization: a prospective randomized study comparing tris-acryl gelatin microspheres versus polyvinyl alcohol microspheres.  J Vasc Interv Radiol. 2008;  19(1) 58-65
    CrossrefPubMedSearch in Google Scholar
  • 28 Kroencke T J, Scheurig C, Lampmann L et al.. Acrylamido polyvinyl alcohol microspheres for uterine artery embolization: 12-month clinical and MR imaging results.  J Vasc Interv Radiol. 2008;  19(1) 47-57
    CrossrefPubMedSearch in Google Scholar
  • 29 Spies J B, Ascher S A, Roth A R. Uterine artery embolization for leiomyomata.  Obstet Gynecol. 2001;  98 29-34
    CrossrefPubMedSearch in Google Scholar
  • 30 Walker W J, Pelage J P. Uterine artery embolization for symptomatic fibroids: clinical result in 400 women with imaging follow up.  BJOG. 2002;  109 1262-1272
    CrossrefPubMedSearch in Google Scholar
  • 31 Pron G, Bennett J, Common A et al.. The Ontario Uterine Fibroid Embolization Trial. Part 2. Uterine fibroid reduction and symptom relief after uterine artery embolization for fibroids.  Fertil Steril. 2003;  79(1) 120-127
    CrossrefPubMedSearch in Google Scholar
  • 32 Goodwin S C, Spies J B, Worthington-Kirsch R et al.. Uterine artery embolization for treatment of leiomyomata: long-term outcomes from the FIBROID Registry.  Obstet Gynecol. 2008;  111(1) 22-33
    CrossrefPubMedSearch in Google Scholar
  • 33 Hovsepian D M, Siskin G P, Bonn J et al.. Quality improvement guidelines for uterine artery embolization for symptomatic fibroids.  J Vasc Interv Radiol. 2004;  15 535-541
    PubMedSearch in Google Scholar

Carin GonsalvesM.D. 

Assistant Professor of Radiology, Division of Cardiovascular and Interventional Radiology, Thomas Jefferson University Hospital

132 South 10th St., Main Building Suite 766, Philadelphia, PA 19107

Email: carin.gonsalves@jefferson.edu