Arterial embolisation to treat uterine myomata

Ravina, J; Ciraru-Vigneron, N; Bouret, J. M.; Herbreteau, Denis; Houdart, Emmanuel; Aymard, A; Merland, J. J.

doi:10.1016/s0140-6736(95)92282-2

Cited by 988 publications

(475 citation statements)

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“…8 With a mean follow-up of 20 months, symptoms resolved in 11 (16). Three patients had partial improvement, and the residual heavy bleeding subsequently controlled with progestins.…”

Section: Discussionmentioning

confidence: 99%

Uterine artery embolisation

Bhardwaj

2012

Indian Heart Journal

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A B S T R A C TPurpose of study: Fibroids are commonest benign tumour of the uterus. It presents with bleeding per vagina in most of the cases. Surgical treatment consists of myomectomy or hysterectomy with or without salpingo oophrectomy, with its inherent morbidity, prolonged hospital stay and psychosocial problems. Surgery is not the best option especially in unmarried and nullipara. Materials and methods:Thirty-five patients were subjected to uterine artery embolisation (UAE).Mean age was 35.51 ± 7.36 years. Two patients were suffering from advanced carcinoma of cervix, 32 had fibroid of uterus, one had endometriosis. Three patients were unmarried, three did not have any issue, three had associated haemodynamically significant cardiac disorders, one had polycystic renal disease, and one had hypernephroma. Four patients had multiple fibroids. The UAE was done through contralateral femoral artery puncture, bilaterally, with the help of Judkin's right coronary catheter. Ultrasound was repeated after 3 months. Results:The UAE was successful in all patients. Mean procedural time was 75 minutes. Hospital stay was 1 day only. Bleeding stopped in all 35 patients. One patient had recurrence of bleeding after 2 months and underwent surgery. Fibroids disappeared in eight patients, decreased in size by > 75% in 11 patients, and by 50-75% in six patients. Five patients did not report back with ultrasound. Two patients had normal delivery after UAE. Uterine fibroids are among the most common tumours of the female reproductive tract that occur in pre-menopausal women. In one study of women, 17-44 years of age undergoing tubal sterilisation, fibroids were found in 9% of whites and 16% of blacks. 1 The overall incidence has been reported to be 29.7/1000 patient/year, with considerable variation according to age. 2 In most studies, the peak incidence has been shown to occur among women who are in their early to mid-40s. 3,4 These are among the commonest causes of bleeding per vagina (P/V), among young females. Other causes of bleeding are ante-partum haemorrhage, post partum haemorrhage, dysfunctional uterine bleeding, and carcinoma of uterus and cervix. Conclusion Materials and methodsThirty-five non-randomised patients having excessive bleeding P/V were taken up for uterine artery embolisation (UAE). All the patients were evaluated in the Obstetrics and Gynaecology (OBG) Department of our college. All were subjected to clinical examination followed by ultrasonography. The patients suspected to have malignancy were subjected to endometrial biopsy. Those found to have malignancy were excluded. Patients found to have uterine fibroids or advanced stage of malignancy, not responding to chemotherapy/radiotherapy were taken up for UAE. The patients were explained the procedure and the possible complications. Only if they agree for the procedure, were they taken up for UAE.The procedure was done under local anaesthesia. Urinary bladder was catheterised. Bilateral femoral artery puncture

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“…8 With a mean follow-up of 20 months, symptoms resolved in 11 (16). Three patients had partial improvement, and the residual heavy bleeding subsequently controlled with progestins.…”

Section: Discussionmentioning

confidence: 99%

Uterine artery embolisation

Bhardwaj

2012

Indian Heart Journal

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“…[1][2][3][4][5] Information on its effects on fertility and infertility, however, is limited. Advice often given to women with uterine fibroids who desire to retain fertility is to avoid UAE.…”

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confidence: 99%

Pregnancy after uterine artery embolization for leiomyomata: A series of 56 completed pregnancies

Walker

McDowell

2006

American Journal of Obstetrics and Gynecology

153

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“…Recently, this technique has been adopted to treat bleeding uterine leiomyomas (uterine fibroids) [28,29]. When first applied to the management of uterine fibroids, bilateral uterine artery embolization was used to control intraoperative bleeding during fibroid surgery [30][31][32]. It has more recently been adopted to control bleeding uterine fibroids nonsurgically [33].…”

Section: Discussionmentioning

confidence: 99%

Near‐fatal uterine hemorrhage during induction chemotherapy for acute myeloid leukemia: A case report of bilateral uterine artery embolization

2004

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Severe transfusion-dependent uterine hemorrhage is a relatively uncommon complication of induction chemotherapy for acute myeloid leukemia (AML). Even less common is the failure of systemic conjugated estrogens in this setting. We report a case of lifethreatening uterine hemorrhage in a 38-year-old woman in the setting of transfusionrefractory thrombocytopenia after completing induction chemotherapy for AML. She experienced dramatic breakthrough uterine hemorrhage despite multiple platelet transfusions, conjugated estrogens, recombinant factor VIIa, '-aminocaproic acid, and intracavitary thrombin-soaked gauze tamponade. At the point of near-exsanguination in the setting of hypotension, hematocrit of 14%, and a platelet count of 3,000/mL, she underwent bilateral uterine artery embolization which proved immediately successful. We review the literature and indications for this procedure in the oncologic patient care setting. Am.

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Arterial embolisation to treat uterine myomata

Cited by 988 publications

References 1 publication

Uterine artery embolisation

Uterine artery embolisation

Pregnancy after uterine artery embolization for leiomyomata: A series of 56 completed pregnancies

Near‐fatal uterine hemorrhage during induction chemotherapy for acute myeloid leukemia: A case report of bilateral uterine artery embolization

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