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Uterine Artery Embolization Safe and Effective Option for Treatment of Symptomatic Uterine Leiomyomas

February 27, 2008
Written by: , Filed in: Interventional Radiology, Obstetric Ultrasound
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Background
Over the past 10 years, uterine artery embolization (UAE) has been proven to be an effective and safe treatment option for symptomatic uterine leiomyomas. The most severe form of the disease is diffuse uterine leiomyomatosis.

Objective
The objective of a recent study was to present a case series describing the success of UAE in patients with diffuse uterine leiomyomatosis.

The study has concluded that on MR imaging, numerous tumors of various sizes are noted without discernable normal myometrium.

Methodology
Over a period of six years, 286 patients received UAE; of these, six patients (2%) had diffuse uterine leiomyomatosis. Their UAE was considered technically successful. Patients were followed-up a mean of 16 months following their UAE therapy. Patients completed a standardized clinical questionnaire prior to therapy and at follow-up.

Interventional Radiology Review
 University of California San Francisco Department of Radiology
  Interventional Radiology Review is an excellent program to view a wide variety of unknown cases. Topics covered include Vascular Interventions and Non Vascular interventions such as:
 
 • Evaluation of Vascular Trauma
 • Arterial and Venous Catheter Angiography
 • Magnetic Resonance Angiography
 • Cholangiography
 • Chest Interventions
 • Nephrostomy and Ureteral Stents
 
  Earn up to 26 AMA PRA Category 1 Credits™.  
  Click here to read more or order: Interventional Radiology Review

Result of the Study
Six patients with diffuse leiomyomatosis were treated with standard UAE. MRI follow-up occurred at a median of 16 months. At the 16-month follow-up, five of the six women had permanent alleviation of symptoms.

One patient had clinical failure at four-months follow up. She experienced a paradoxical increase in symptoms post-UAE and uterine volume increased by 140%. The patient had a hysterectomy for suspected malignancy, but pathology report proved benign disease.

The median age of patients with diffuse leiomyomatosis was younger than standard patients with fibroids. Leiomyoma infarction in the five patients led to a remodeling of normal myometrium. A larger decrease in uterus volume and a higher rate of spontaneous expulsion of fibroids were noted.

Conclusions
UAE can be an effective therapeutic procedure in patients with diffuse uterine leiomyomatosis. Traditional surgery includes hysterectomy and hysteroscopic myomectomy of dominant submucosal fibroids.

Author: Sohail Contractor, MD

Reference
Scheung C, Islam T, et al. Uterine Artery Embolization in Patients With Symptomatic Diffuse Leiomyomatosis of the Uterus. J Vasc Interv Radiol; 2008; 18 (February): 279-284:

Interventional Radiology Review
 University of California San Francisco Department of Radiology
  Interventional Radiology Review is an excellent program to view a wide variety of unknown cases. Topics covered include Vascular Interventions and Non Vascular interventions such as:
 
 • Evaluation of Vascular Trauma
 • Arterial and Venous Catheter Angiography
 • Magnetic Resonance Angiography
 • Cholangiography
 • Chest Interventions
 • Nephrostomy and Ureteral Stents
 
  Earn up to 26 AMA PRA Category 1 Credits™.  
  Click here to read more or order: Interventional Radiology Review
.

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