Updates on Uterine Artery Embolization.
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This review discusses uterine artery embolization as a well-established, minimally invasive therapy for symptomatic uterine fibroids, focusing on emerging technical approaches and novel periprocedural patient care.
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This review article evaluates uterine artery embolization as a well-established, minimally invasive, and uterine-preserving treatment for symptomatic uterine fibroids. It highlights emerging technical approaches, such as transradial access and novel embolic agents, alongside periprocedural care strategies like nerve blocks to manage pain and reduce complications. The text notes that while strong evidence supports the safety and efficacy of this therapy with low complication rates, it primarily addresses fibroid management rather than other pathologies. Relevance to endometriosis: listed among references regarding adenomyosis treatment outcomes, though the paper's main focus is uterine fibroids.
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Abstract
Uterine fibroids (leiomyomas) are the most common benign neoplasm of the female pelvis and have a lifetime prevalence exceeding 80% among African American women and approaching 70% among Caucasian women. Approximately 50% of women with fibroids experience symptoms which may include menorrhagia that may result in anemia, bulk symptoms with bladder and bowel dysfunction and abdominal protrusion, dysmenorrhea, and infertility. Hysterectomy remains the most common treatment option for fibroids and concerns have been raised about the overuse of this procedure. Uterine artery embolization (UAE) is now a well-established uterine preserving and minimally invasive therapy for symptomatic fibroids. Since its introduction, strong evidence for safety and efficacy of UAE has been generated with low rates of complications. This review will discuss UAE for the management of symptomatic uterine fibroids with special focus on emerging technical approaches and novel periprocedural patient care.
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Abstract
Uterine fibroids (leiomyomas) are the most common benign neoplasm of the female pelvis and have a lifetime prevalence exceeding 80% among African American women and approaching 70% among Caucasian women. Approximately 50% of women with fibroids experience symptoms which may include menorrhagia that may result in anemia, bulk symptoms with bladder and bowel dysfunction and abdominal protrusion, dysmenorrhea, and infertility. Hysterectomy remains the most common treatment option for fibroids and concerns have been raised about the overuse of this procedure. Uterine artery embolization (UAE) is now a well-established uterine preserving and minimally invasive therapy for symptomatic fibroids. Since its introduction, strong evidence for safety and efficacy of UAE has been generated with low rates of complications. This review will discuss UAE for the management of symptomatic uterine fibroids with special focus on emerging technical approaches and novel periprocedural patient care.
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References
- 1 Stewart EA. Clinical practice. Uterine fibroids. N Engl J Med 2015; 372 (17) 1646-1655
- 2 Silberzweig JE, Powell DK, Matsumoto AH, Spies JB. Management of uterine fibroids: a focus on uterine-sparing interventional techniques. Radiology 2016; 280 (03) 675-692
- 3 Stewart EA, Shuster LT, Rocca WA. Reassessing hysterectomy. Minn Med 2012; 95 (03) 36-39
- 4 Ravina JH, Herbreteau D, Ciraru-Vigneron N. , et al. Arterial embolisation to treat uterine myomata. Lancet 1995; 346 (8976): 671-672
- 5 Spies JB. Current evidence on uterine embolization for fibroids. Semin Intervent Radiol 2013; 30 (04) 340-346
- 6 Spies JB. Current role of uterine artery embolization in the management of uterine fibroids. Clin Obstet Gynecol 2016; 59 (01) 93-102
- 7 Dariushnia SR, Nikolic B, Stokes LS, Spies JB. ; Society of Interventional Radiology Standards of Practice Committee. Quality improvement guidelines for uterine artery embolization for symptomatic leiomyomata. J Vasc Interv Radiol 2014; 25 (11) 1737-1747
- 8 Rajan DK, Margau R, Kroll RR. , et al. Clinical utility of ultrasound versus magnetic resonance imaging for deciding to proceed with uterine artery embolization for presumed symptomatic fibroids. Clin Radiol 2011; 66 (01) 57-62
- 9 Siddiqui N, Nikolaidis P, Hammond N, Miller FH. Uterine artery embolization: pre- and post-procedural evaluation using magnetic resonance imaging. Abdom Imaging 2013; 38 (05) 1161-1177
- 10 Zhou J, He L, Liu P. , et al. Outcomes in adenomyosis treated with uterine artery embolization are associated with lesion vascularity: a long-term follow-up study of 252 cases. PLoS One 2016; 11 (11) e0165610
- 11 Popovic M, Puchner S, Berzaczy D, Lammer J, Bucek RA. Uterine artery embolization for the treatment of adenomyosis: a review. J Vasc Interv Radiol 2011; 22 (07) 901-909 , quiz 909
- 12 Bae SH, Kim MD, Kim GM. , et al. Uterine artery embolization for adenomyosis: percentage of necrosis predicts midterm clinical recurrence. J Vasc Interv Radiol 2015; 26 (09) 1290-6.e2
- 13 Turok DK, Gawron LM, Lawson S. New developments in long-acting reversible contraception: the promise of intrauterine devices and implants to improve family planning services. Fertil Steril 2016; 106 (06) 1273-1281
- 14 Smeets AJ, Nijenhuis RJ, Boekkooi PF, Vervest HA, van Rooij WJ, Lohle PN. Is an intrauterine device a contraindication for uterine artery embolization? A study of 20 patients. J Vasc Interv Radiol 2010; 21 (02) 272-274
- 15 Wu TI, Yen TC, Lai CH. Clinical presentation and diagnosis of uterine sarcoma, including imaging. Best Pract Res Clin Obstet Gynaecol 2011; 25 (06) 681-689
- 16 Barral M, Placé V, Dautry R. , et al. Magnetic resonance imaging features of uterine sarcoma and mimickers. Abdom Radiol (NY) 2017; 42 (06) 1762-1772
- 17 Chrisman HB, Minocha J, Ryu RK, Vogelzang RL, Nikolaidis P, Omary RA. Uterine artery embolization: a treatment option for symptomatic fibroids in postmenopausal women. J Vasc Interv Radiol 2007; 18 (03) 451-454
- 18 Lee SJ, Kim MD, Kim GM, Won JY, Park SI, Lee DY. Uterine artery embolization for symptomatic fibroids in postmenopausal women. Clin Imaging 2016; 40 (01) 106-109
- 19 Katsumori T, Nakajima K, Mihara T. Is a large fibroid a high-risk factor for uterine artery embolization?. AJR Am J Roentgenol 2003; 181 (05) 1309-1314
- 20 Bérczi V, Valcseva É, Kozics D. , et al. Safety and effectiveness of UFE in fibroids larger than 10 cm. Cardiovasc Intervent Radiol 2015; 38 (05) 1152-1156
- 21 Smeets AJ, Nijenhuis RJ, van Rooij WJ. , et al. Uterine artery embolization in patients with a large fibroid burden: long-term clinical and MR follow-up. Cardiovasc Intervent Radiol 2010; 33 (05) 943-948
- 22 Singh SS, Belland L. Contemporary management of uterine fibroids: focus on emerging medical treatments. Curr Med Res Opin 2015; 31 (01) 1-12
- 23 Volkers NA, Hehenkamp WJ, Birnie E. , et al. Uterine artery embolization in the treatment of symptomatic uterine fibroid tumors (EMMY trial): periprocedural results and complications. J Vasc Interv Radiol 2006; 17 (03) 471-480
- 24 Hutchins FL, Worthington-Kirsch R, Berkowitz RP. GnRH analogs and uterine artery embolization. J Am Assoc Gynecol Laparosc 1999; 6 (03) 367-368
- 25 Kim MD, Lee M, Lee MS. , et al. Uterine artery embolization of large fibroids: comparative study of procedure with and without pretreatment gonadotropin-releasing hormone agonists. AJR Am J Roentgenol 2012; 199 (02) 441-446
- 26 Gonsalves C. Uterine artery embolization for treatment of symptomatic fibroids. Semin Intervent Radiol 2008; 25 (04) 369-377
- 27 Katsumori T, Akazawa K, Mihara T. Uterine artery embolization for pedunculated subserosal fibroids. AJR Am J Roentgenol 2005; 184 (02) 399-402
- 28 Margau R, Simons ME, Rajan DK. , et al. Outcomes after uterine artery embolization for pedunculated subserosal leiomyomas. J Vasc Interv Radiol 2008; 19 (05) 657-661
- 29 Smeets AJ, Nijenhuis RJ, Boekkooi PF. , et al. Safety and effectiveness of uterine artery embolization in patients with pedunculated fibroids. J Vasc Interv Radiol 2009; 20 (09) 1172-1175
- 30 Lacayo EA, Richman DL, Acord MR. , et al. Leiomyoma infarction after uterine artery embolization: influence of embolic agent and leiomyoma size and location on outcome. J Vasc Interv Radiol 2017; 28 (07) 1003-1010
- 31 Stall L, Lee J, McCullough M, Nsrouli-Maktabi H, Spies JB. Effectiveness of elective unilateral uterine artery embolization: a case-control study. J Vasc Interv Radiol 2011; 22 (05) 716-722
- 32 Costantino M, Lee J, McCullough M, Nsouli-Maktabi H, Spies JB. Bilateral versus unilateral femoral access for uterine artery embolization: results of a randomized comparative trial. J Vasc Interv Radiol 2010; 21 (06) 829-835 , quiz 835
- 33 Resnick NJ, Kim E, Patel RS, Lookstein RA, Nowakowski FS, Fischman AM. Uterine artery embolization using a transradial approach: initial experience and technique. J Vasc Interv Radiol 2014; 25 (03) 443-447
- 34 Fischman AM, Swinburne NC, Patel RS. A technical guide describing the use of transradial access technique for endovascular interventions. Tech Vasc Interv Radiol 2015; 18 (02) 58-65
- 35 Das R, Champaneria R, Daniels JP, Belli AM. Comparison of embolic agents used in uterine artery embolisation: a systematic review and meta-analysis. Cardiovasc Intervent Radiol 2014; 37 (05) 1179-1190
- 36 Kroencke TJ, Scheurig C, Lampmann LE. , et al. Acrylamido polyvinyl alcohol microspheres for uterine artery embolization: 12-month clinical and MR imaging results. J Vasc Interv Radiol 2008; 19 (01) 47-57
- 37 Chrisman HB, Dhand S, Rajeswaran S. , et al. Prospective evaluation of the embolic agent bead block in the treatment of uterine leiomyomas with uterine artery embolization: a phase II study. J Vasc Interv Radiol 2010; 21 (04) 484-489
- 38 Worthington-Kirsch RL, Siskin GP, Hegener P, Chesnick R. Comparison of the efficacy of the embolic agents acrylamido polyvinyl alcohol microspheres and tris-acryl gelatin microspheres for uterine artery embolization for leiomyomas: a prospective randomized controlled trial. Cardiovasc Intervent Radiol 2011; 34 (03) 493-501
- 39 Stampfl U, Radeleff B, Sommer C. , et al. Midterm results of uterine artery embolization using narrow-size calibrated embozene microspheres. Cardiovasc Intervent Radiol 2011; 34 (02) 295-305
- 40 Smeets AJ, Nijenhuis RJ, van Rooij WJ. , et al. Embolization of uterine leiomyomas with Polyzene F-coated hydrogel microspheres: initial experience. J Vasc Interv Radiol 2010; 21 (12) 1830-1834
- 41 Razavi MK, Wolanske KA, Hwang GL, Sze DY, Kee ST, Dake MD. Angiographic classification of ovarian artery-to-uterine artery anastomoses: initial observations in uterine fibroid embolization. Radiology 2002; 224 (03) 707-712
- 42 Lanciego C, Diaz-Plaza I, Ciampi JJ. , et al. Utero-ovarian anastomoses and their influence on uterine fibroid embolization. J Vasc Interv Radiol 2012; 23 (05) 595-601
- 43 Hu NN, Kaw D, McCullough MF, Nsouli-Maktabi H, Spies JB. Menopause and menopausal symptoms after ovarian artery embolization: a comparison with uterine artery embolization controls. J Vasc Interv Radiol 2011; 22 (05) 710-715.e1
- 44 Chang S, Lee MS, Kim MD. , et al. Inferior mesenteric artery collaterals to the uterus during uterine artery embolization: prevalence, risk factors, and clinical outcomes. J Vasc Interv Radiol 2013; 24 (09) 1353-1360
- 45 Saraiya PV, Chang TC, Pelage JP, Spies JB. Uterine artery replacement by the round ligament artery: an anatomic variant discovered during uterine artery embolization for leiomyomata. J Vasc Interv Radiol 2002; 13 (9, Pt 1): 939-941
- 46 Binkert CA, Hirzel FC, Gutzeit A, Zollikofer CL, Hess T. Superior hypogastric nerve block to reduce pain after uterine artery embolization: advanced technique and comparison to epidural anesthesia. Cardiovasc Intervent Radiol 2015; 38 (05) 1157-1161
- 47 Yoon J, Toonsi F, Valenti D, Muchantef K, Cabrera T, Boucher L. Superior Hypogastric Nerve Block (SHGNB) as post uterine artery embolization (UAE) analgesia: a prospective, randomized, double-blinded study. Paper presented at: Annual Meeting of the Society of Interventional Radiology; March 8, 2017; Washington, DC
- 48 Kim SY, Koo BN, Shin CS, Ban M, Han K, Kim MD. The effects of single-dose dexamethasone on inflammatory response and pain after uterine artery embolisation for symptomatic fibroids or adenomyosis: a randomised controlled study. BJOG 2016; 123 (04) 580-587
- 49 Keyoung JA, Levy EB, Roth AR, Gomez-Jorge J, Chang TC, Spies JB. Intraarterial lidocaine for pain control after uterine artery embolization for leiomyomata. J Vasc Interv Radiol 2001; 12 (09) 1065-1069
- 50 Noel-Lamy M, Tan KT, Simons ME, Sniderman KW, Mironov O, Rajan DK. Intraarterial lidocaine for pain control in uterine artery embolization: a prospective, randomized study. J Vasc Interv Radiol 2017; 28 (01) 16-22
- 51 Gupta JK, Sinha A, Lumsden MA, Hickey M. Uterine artery embolization for symptomatic uterine fibroids. Cochrane Database Syst Rev 2014; (12) CD005073
- 52 Barnard EP, AbdElmagied AM, Vaughan LE. , et al. Periprocedural outcomes comparing fibroid embolization and focused ultrasound: a randomized controlled trial and comprehensive cohort analysis. Am J Obstet Gynecol 2017; 216 (05) 500.e1-500.e11
- 53 Froeling V, Meckelburg K, Schreiter NF. , et al. Outcome of uterine artery embolization versus MR-guided high-intensity focused ultrasound treatment for uterine fibroids: long-term results. Eur J Radiol 2013; 82 (12) 2265-2269
- 54 Shlansky-Goldberg RD, Coryell L, Stavropoulos SW. , et al. Outcomes following fibroid expulsion after uterine artery embolization. J Vasc Interv Radiol 2011; 22 (11) 1586-1593
- 55 Radeleff B, Eiers M, Bellemann N. , et al. Expulsion of dominant submucosal fibroids after uterine artery embolization. Eur J Radiol 2010; 75 (01) e57-e63
- 56 Mara M, Maskova J, Fucikova Z, Kuzel D, Belsan T, Sosna O. Midterm clinical and first reproductive results of a randomized controlled trial comparing uterine fibroid embolization and myomectomy. Cardiovasc Intervent Radiol 2008; 31 (01) 73-85
- 57 Torre A, Fauconnier A, Kahn V, Limot O, Bussierres L, Pelage JP. Fertility after uterine artery embolization for symptomatic multiple fibroids with no other infertility factors. Eur Radiol 2017; 27 (07) 2850-2859
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