Incidence and predictive factors for complications after uterine leiomyoma embolization

Tropeano, Giovanna; Amoroso, Sonia; Stasi, Carmine Di; Bidino, Rossella Di; Monterisi, Aída; Petrillo, Marco; Scambia, Giovanni

doi:10.1093/humrep/deu166

Cited by 15 publications

(12 citation statements)

References 28 publications

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“…Uterine artery embolization (UAE): an interventional radiologist identifies the uterine vessels that supply the fibroids and occlude the vessels with trisacryl gelatin microspheres or polyvinyl alcohol particles. 10 , 11 Usually, the approach is via the transcutaneous femoral artery. Fibroids undergo devascularization and ultimately involution.…”

Section: Methodsmentioning

confidence: 99%

Symptomatic Fibroid Management: Systematic Review of the Literature

Havryliuk

Setton

Carlow³

et al. 2017

JSLS

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Background and Objectives:Symptomatic uterine fibroids are a societal and healthcare burden with no clear consensus among medical professionals as to which procedural treatment is most appropriate for each symptomatic patient. Our purpose was to determine whether recommendations can be made regarding best practice based on review and analysis of the literature since 2006.Database:A systematic search of journal articles relevant to the treatment of symptomatic uterine fibroids was performed within PubMed, clinical society websites, and medical device manufacturers' websites. All clinical trials published in English, representing original research, and reporting clinical outcomes associated with interventions for the management of symptomatic uterine fibroids were considered. Each article was screened and selected based on study type, content, relevance, American College of Obstetricians and Gynecologists score, and internal/external validity. Outcomes of interest were patient baseline characteristics, fibroid characteristics, procedural details, complications, and long-term follow-up. Random-effects meta-analyses were used to test the quantitative data. Assessment of 143 full-length articles through January 2016 produced 45 articles for the quantitative analysis. The weighted combined results from hysterectomy trials were compared with those from uterine-preserving fibroid studies (myomectomy, uterine artery embolization, laparoscopic radiofrequency ablation, and magnetic resonance-guided focused ultrasound).Conclusion:We explored trends that might guide clinicians when counseling patients who need treatment of symptomatic fibroids. We found that fibroid therapy is trending toward uterine-conserving treatments and outcomes are comparable across those treatments. Since minimally invasive options are increasing, it is important for the clinician to provide the patient with evidence-based therapeutic strategies.

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Section: Methodsmentioning

confidence: 99%

Symptomatic Fibroid Management: Systematic Review of the Literature

Havryliuk

Setton

Carlow³

et al. 2017

JSLS

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“…However, early pathological changes of UFs cannot be detected accurately based only on clinical signs and imaging characteristics. Since MRI gives better image quality than CT does by displaying UF foci more clearly without being affected by bones, MRI is preferred to CT now in order to ensure successful UAE 16. In this study, the two groups had similar uterine and fibroid sizes before treatment, which were all significantly reduced after treatment (P<0.05) when the treatment group had significantly smaller uteri and fibroids than the control group did (P<0.05), suggesting that the patients were treated more effectively by MRI-guided UAE.…”

Section: Discussionmentioning

confidence: 99%

A comparative study on the effects of MRI- and CT-guided interventional therapies on uterine fibroids

Ye¹,

Yan²,

He³

et al. 2016

Pak J Med Sci

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Objective:To compare the effects of MRI- and CT-guided interventional therapies on uterine fibroids.Methods:A total of 280 patients with uterine fibroids who were treated in our hospital from August 2008 to February 2014 were selected and divided into a treatment group and a control group by random draw (n=140). The control group and the treatment group were subjected to CT- and MRI-guided interventional therapies for uterine artery embolization.Results:After three months of treatment, 94.3% and 92.9% of heavy menstrual bleeding and pelvic pressure of the treatment group were relieved respectively, which were similar to those of the control group (92.9% and 92.1% respectively) (P>0.05). The two groups had similar uterine and fibroid sizes before treatment, which were all significantly decreased after treatment (P<0.05) when the treatment group had significantly smaller uteri and fibroids than the control group did (P<0.05). The serum follicle-stimulating hormone, luteinizing hormone, estradiol levels, arterial resistive indices and endometrial thicknesses of the two groups were similar before treatment, which were significantly increased after treatment (P<0.05). Meanwhile, the values of the two groups became significantly different (P<0.05). The treatment group was also significantly less prone to complications such as fever, vaginal bleeding and hematuria than the control group after treatment (P<0.05).Conclusion:Interventional therapy, especially that guided by MRI, can be performed accurately and safely by mildly affecting the ovary and by promoting the recovery of uterine artery blood flow and endometrial thickness.

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“…И нашей целью было выявить морфологические особенности тканей мат-ки после воздействия вышеуказанных методов. Хотя в литературе [1,9,11] имеется достаточно данных о положительном эффекте указанных альтернативных методик, считаем целесообразно продолжить иссле-дования для поиска новых критериев эффективного применения альтернативных методов лечения мио-мы матки у женщин репродуктивного возраста, стра-дающих бесплодием. Принципиальным в этой связи следует рассматривать вопрос о проведении суперсе-лективной ЭМА, что, по-видимому, позволит сни-зить частоту осложнений.…”

Section: заключениеunclassified

“…Хотя в мире описано более 300 случаев беременности и родов после ЭМА [9] и более 100 после ФУЗ-МРТ абляции [10], остает-ся открытым вопрос о показаниях к использованию этих методов у женщин, желающих сохранить или восстановить репродуктивную функцию. Это связа-но с развитием таких осложнений беременности у пациенток данных групп, как преждевременные ро-ды, самопроизвольные выкидыши, неправильное предлежание плода, увеличение частоты кесарева се-чения, а также осложненное течение послеопераци-онного периода [9,11].…”

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Surgical treatment of uterine myoma after ineffective UAE and MRgFUS ablation

Porotikova¹,

Adamyan²,

Gavrilova³

et al. 2016

Probl. reprod.

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Миома матки является доброкачественной, хо-рошо ограниченной капсулированной опухолью, ко-торая развивается из мышечной ткани и имеет моно-клональное происхождение [1][2][3][4][5][6]. Это второе по ча-e-mail: irinaevgdoc@gmail.com стоте заболевание у женщин репродуктивного воз-раста, которое составляет, по данным разных авто-ров [2,4,5], от 10 до 30% всех гинекологических за-болеваний. Миома матки может иметь симптомное и Цель исследования -оценка характера изменений органов репродуктивной системы у женщин после ранее перенесенной неэффективной ЭМА, ФУЗ-МРТ абляции и миомэктомии (МЭ) на основании интраоперационных наблюдений. Материал и методы. Обследованы 110 женщин с наличием в анамнезе неэффективного лечения миомы матки с помощью ЭМА и ФУЗ-МРТ абляции и МЭ. Указанным пациенткам нами была проведена МЭ. 1-ю группу составили 32 пациентки с наличием в анамнезе ЭМА, 2-ю группу -26 пациенток с наличием в анамнезе ФУЗ-МРТ абляции миомы и 3-ю группу -52 пациентки, ранее перенесшие МЭ. Результаты. В 1-й группе отмечались трудности при вылущивании миоматозных узлов в связи с наличием конгломератов у 13 (40,6%) пациенток, отсутствием четких границ миомы -у 23 (71,9%), явлением некроза -у 20 (62,5%), явлениями отека -у 15 (46,9%) и наличием дегенеративных изменений -у 29 (90,6%) (p<0,05). Во 2-й группе конгломераты узлов были выявлены у 7 (26,9%), отсутствие четких границ миомы -у 5 (19,2%), явления отека -у 8 (30,8%), явления некроза -у 9 (34,6%), дегенеративные изменения миоматозных узлов -у 13 (50%). Выводы. Необходимо продолжить исследование для поиска новых критериев применения альтернативных методов лечения миомы матки у женщин репродуктивного возраста, страдающих бесплодием. Objective -to estimate the character of the changes of the reproductive system in women after previously made ineffective EMA, MRgFUS ablation and myomectomy on the basis of intraoperative observations. Material and methods. 110 women with a history of ineffective treatment of uterine fibroids with UAE, MRgFUS ablation and myomectomy. All patients had myomectomy. Group I included 32 patients with a history of UAE, II group consisted of 26 patients with a history of MRgFUS ablation of fibroids and III group contained 52 patients with previously made myomectomy. Ключевые слова: миома матки, миомэктомия, эмболизация маточных артерий, фокусированный ультразвук, магнитно-резонансная томография. Surgical treatment of uterine myoma after ineffective UAE and MRgFUS ablationResults. It was difficult to remove the fibroids in Group I due to the presence of conglomerates in 13 (40.6%) patients, the absence of clear borders fibroids of fibroids in 23 (71.9%) patients, necrosis phenomenon in 20 (62.5%) patients, edema -in 15 (46.9%) and the presence of degenerative changes -in 29 (90.6%) (p<0.05). In Group II conglomerates were identified in 7 (26.9%) patients, the absence of clear borders of fibroids -in 5 (19.2%), edema -in 8 (30.8%), the necrosis -in 9 (34,6%), degenerative changes of myoma -in 13 (50%). Conclusion. It is necessary to continue the resea...

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Incidence and predictive factors for complications after uterine leiomyoma embolization

Abstract: The authors have no competing interests to declare. The study was not supported by any external grant.

Cited by 15 publications

References 28 publications

Symptomatic Fibroid Management: Systematic Review of the Literature

Symptomatic Fibroid Management: Systematic Review of the Literature

A comparative study on the effects of MRI- and CT-guided interventional therapies on uterine fibroids

Surgical treatment of uterine myoma after ineffective UAE and MRgFUS ablation

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