Patient Care and Uterine Artery Embolization for Leiomyomata

Andrews, Robert T.; Spies, James B.; Sacks, David; Worthington-Kirsch, Robert L.; Niedzwiecki, Gerald A.; Marx, M. Victoria; Hovsepian, David M.; Miller, Donald L.; Siskin, Gary P.; Raabe, Rodney D.; Goodwin, Scott C.; Min, Robert J.; Bonn, Joseph; Cardella, John F.; Patel, Nilesh H.

doi:10.1016/j.jvir.2009.04.002

Cited by 22 publications

(12 citation statements)

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“…There are no absolute contraindications to embolization for treatment of a life-threatening hemorrhage. Contraindications to elective embolization include previous pelvic irradiation, which increases the risk for uterine necrosis; stage 4 or 5 chronic kidney disease; severe allergy to contrast material; acute or chronic pelvic infection; refractory coagulopathy; use of gonadotropin-releasing hormone analogues, which may cause constriction of the uterine arteries; intrauterine pregnancy with normal placental implantation (ie, in the absence of placenta accreta); and nonhemorrhagic gynecologic malignancy, except when elective embolization is performed for palliation of advanced-stage disease or as an adjunct to surgery, to control bleeding (7).…”

Section: General Indications and Contraindicationsmentioning

confidence: 99%

“…Most women with symptomatic fibroids are candidates for UFE. Contraindications include uterine infection, pregnancy, and gynecologic malignancy (7). Although excellent clinical results are obtained in 80%-90% of patients, the outcome of UFE varies: When menorrhagia is the predominant symptom, the procedure almost invariably results in clinical improvement.…”

Section: Gynecologic Indications For Transcatheter Embolization Uterimentioning

confidence: 99%

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Beyond Hemostasis: Spectrum of Gynecologic and Obstetric Indications for Transcatheter Embolization

Katz¹,

Sugay²,

Walker³

et al. 2012

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Percutaneous vascular embolization is a useful therapeutic option for a wide range of gynecologic and obstetric abnormalities. Transcatheter embolization procedures performed with the use of radiologic imaging for guidance are minimally invasive and may obviate surgery, thereby decreasing morbidity and mortality and safeguarding the patient's future fertility potential. To integrate this treatment method optimally into patient care, knowledge is needed about the clinical indications for therapeutic embolization, the relevant vascular anatomy, technical considerations of the procedure, and the potential risks and benefits of embolization. The most well-known and well-studied transcatheter embolization technique for treating a gynecologic-obstetric condition is uterine fibroid embolization. However, the clinical indications for transcatheter embolization are much broader and include many benign gynecologic conditions, such as adenomyosis and arteriovenous malformations, as well as intractable bleeding due to inoperable advanced-stage malignancies. Uterine artery embolization may be performed to prevent or treat bleeding associated with various obstetric conditions, including postpartum hemorrhage, placental implantation abnormality, and ectopic pregnancy. Embolization of the uterine artery or the internal iliac artery also may be performed to control pelvic bleeding due to coagulopathy or iatrogenic injury, and ovarian vein embolization has been shown to be effective for the management of pelvic congestion syndrome. The article discusses these and other gynecologic and obstetric indications for transcatheter embolization, provides detailed descriptions of imaging findings before and after embolization, and reviews procedural techniques and outcomes.

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Section: General Indications and Contraindicationsmentioning

confidence: 99%

Section: Gynecologic Indications For Transcatheter Embolization Uterimentioning

confidence: 99%

Beyond Hemostasis: Spectrum of Gynecologic and Obstetric Indications for Transcatheter Embolization

Katz¹,

Sugay²,

Walker³

et al. 2012

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“…Almost all patients who undergo UAE procedures are women of childbearing age, and because UAE requires fluoroscopic and angiographic imaging, the radiation exposure may affect the function of the ovaries (11). Because the patient is exposed to ionizing radiation during UAE, all procedures and radiation exposure should be governed by the principle of as low as reasonably achievable (12).…”

mentioning

confidence: 99%

Uterine Artery Embolization: Optimization with Preprocedural Prediction of the Best Tube Angle Obliquity by Using 3D-Reconstructed Contrast-enhanced MR Angiography

Naguib¹,

Nour-Eldin²,

Lehnert³

et al. 2009

Radiology

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“…3 Bulk-related symptoms, most often caused by an enlarged fibroid uterus, include leg and back pain; pelvic pressure, heaviness or discomfort; abdominal bloating, urinary frequency or incontinence, and constipation. 5 Fibroids are categorized by their relationship to the uterus as submucosal, intramural, or subserosal. Subserosal and submucosal fibroids may be described as exophytic or pedunculated.…”

mentioning

confidence: 99%