Uterine fibroid embolization in women with giant fibroids

被引:5
|
作者
Nasser, Felipe [1 ]
Affffonso, Breno Boueri [1 ]
de Jesus-Silva, Seleno Glauber [1 ]
Coelho, Dionesio de Oliveira [1 ]
Zlotnik, Eduardo [1 ]
Messina, Marcos de Lorenznzo [1 ]
Baracat, Edmund Chada [1 ]
机构
[1] HIAE, Dept Radiologista Intervencionista, Sao Paulo, SP, Brazil
来源
关键词
Uterine fibroids; Uterine artery embolization; Hysterectomy; Embolization; therapeutic; Magnetic resonance imaging; Angiography; digital subtraction;
D O I
10.1590/S0100-72032010001100003
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
PURPOSE: to evaluate the effectiveness of uterine fibroid embolization (UFE) in patients with giant fibroids, with regard to both clinical outcomes and size reduction. METHODS: twenty-six patients with a mean age of 36.5 years, carrying symptomatic fibroids with a volume over 1,000 cm(3), were referred for UFE. All patients had indication for percutaneous treatment. The procedures were performed under epidural anesthesia and sedation, using an institutional protocol. By unilateral femoral access, selective catheterization of uterine arteries and infusion of calibrated microspheres through microcatheter were carried out. Clinical evaluation was performed by means of regular outpatient gynecology consultation. All patients underwent magnetic resonance imaging (MRI) before the procedure and 15 patients underwent control MRI after 6 months. RESULTS: technical success was 100%. There was no complication related to the procedures. Mean uterine volume of the 15 patients studied was 1,401 cm(3) before embolization (min 1,045 cm(3), max 2,137 cm3) and 799 cm(3) after 6 months (525 cm(3) min, max. 1,604 cm(3)), resulting in a total reduction of 42.9%. Clinical improvement was observed in 25 of 26 patients. One woman with uterine volume of 1,098 cm(3) who developed necrosis and partial fibroid expulsion underwent myomectomy. Another patient was submitted to myomectomy six months after the procedure because she wanted to become pregnant, despite partial fibroid size reduction. One patient with a uterine volume of 2,201 cm(3) required a second intervention to achieve an adequate angiographic result. No patient underwent hysterectomy. On average, 9.2 microsphere syringes were used per patient. CONCLUSION: embolization of giant uterine fibroids is a feasible procedure with acceptable clinical and radiological outcomes. It can be considered an option for patients who desire to preserve the uterus, and it may serve as adjuvant therapy for high-risk myomectomy.
引用
收藏
页码:530 / 535
页数:6
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