Abstract
Transcatheter embolization of the uterine arteries for symptomatic fibroid disease has become an increasingly important alternative treatment. It is highly effective and well tolerated by most patients. Most notably, uterine artery embolization is associated with a short recovery period and is uterine sparing. To ensure the best chance for a safe and successful procedure, Interventional Radiologists should have familiarity with uterine artery anatomy, state of the art embolization techniques, and optimal patient selection and post procedure management.
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Ravina JH, Herbreteau D, Ciraru-Viqneron N, et al. (1995) Arterial embolisation to treat uterine myomata. Lancet 346:671–672
Hovsepian DM, Siskin GP, Bonn J, et al. (2004) Quality improvement guidelines for uterine artery embolization for symptomatic leiomyomata. J Vasc Interv Radiol 15:535–541
Heaston DK, Mineau DE, Brown BJ, et al. (1979) Transcatheter arterial embolization for control of persistent massive puerperal hemorrhage after bilateral surgical hypogastric artery ligation. Am J Roentgenol 133:152–154
Brown BJ, Heaston DK, Poulson AM, et al. (1979) Uncontrollable postpartum bleeding: a new approach to hemostasis through angiographic arterial embolization. Obstet Gynecol 54:361–365
Vedantham S, Goodwin SC, McLucas B, et al. (1997) Uterine artery embolization: an underused method of controlling pelvic hemorrhage. Am J Obstet Gynecol 176:938–948
Siskin GP, Shlansky-Goldberg RD, Goodwin SC, et al. (2006) A prospective multicenter comparative study between myomectomy and uterine artery embolization with polyvinyl alcohol microspheres: long-term clinical outcomes in patients with symptomatic uterine fibroids. J Vasc Interv Radiol 17:1287–1295
Vilos GA, Vilos AG, Abu-Rafea B, et al. (2006) Administration of goserelin acetate after uterine artery embolization does not change the reduction rate and volume of uterine myomas. Fertil Steril 85:1478–1483
Lohle PN, Boekkooi FP, Smeets AJ, et al. (2006) Limited uterine artery embolization for leiomyomas with tris-acryl gelatin microspheres: 1-year follow-up. J Vasc Interv Radiol 17:283–287
Spies JB, Bruno J, Czeyda-Pommersheim F, et al. (2005) Long-term outcome of uterine artery embolization for leiomyomata. Obstet Gynecol 106:933–939
Joffre F, Tubiana JM, Pelage JP, et al. (2004) FEMIC (Fibromes Embolises aux MICrospheres calibrees): uterine fibroid embolization using tris-acryl microspheres. A French multicenter study. Cardiovasc Intervent Radiol 27:600–606
Razavi MK, Wolanske KA, Hwang GL, et al. (2002) Angiographic classification of ovarian artery-to-uterine artery anastomoses: initial observations in uterine fibroid embolization. Radiology 224:707–712
Nikolic B, Spies JB, Campbell L, et al. (2001) Uterine artery emboization: reduced radiation with refined technique. J Vasc Interv Radiol 12:39–44
Spies JB, Allison S, Flick P, et al. (2005) Spherical polyvinyl alcohol versus tris-acryl gelatin microspheres for uterine artery embolization for leiomyomas: results of a limited randomized comparative study. J Vasc Interv Radiol 16:1431–1437
Pelage J-P, Le Dref O, Beregi J-P, et al. (2003) Limited uterine artery embolization with tris-acryl gelatin microspheres for uterine fibroids. J Vasc Interv Radiol 14:15–20
Richter GM, Radeleff B, Rimbach S, et al. (2004) Uterine fibroid embolization with spheric micro-particles using flow guiding: safety, technical success and clinical results. Rofo 176:1648–1657
Spies JB, Allison S, Flick P, et al. (2004) PVA particles and tris-acryl gelatin microspheres for UAE for leiomyoma: results of a randomized comparative study. J Vasc Interv Radiol 15:793–800
Katsumori T, Bamba M, Kobasyashi TK, et al. (2002) Uterine leiomyoma after embolization by means of gelatin sponge particles alone: report of a case with histopathologic features. Ann Diagn Pathol 6:307–311
Haung LY, Cheng YE, Chang HW, et al. (2004) Quantified short-term outcome of uterine artery embolization with gelatin sponge particles and lipiodol for symptomatic myoma. Fertil Steril 81:1375–1382
Banovac F, Ascher SM, Jones DA, et al. (2002) Magnetic resonance imaging outcome after uterine artery embolization for leiomyomata with use of tris-acryl gelatin microspheres. J Vasc Interv Radiol 13:681–688
Goodwin SC, McLucas B, Lee M, et al. (1999) Uterine artery embolization for the treatment of uterine leiomyomata: midterm results. J Vasc Interv Radiol 10:1159–1165
Broder MS, Goodwin S, Chen G, et al. (2002) Comparison of long-term outcomes of myomectomy and uterine artery embolization. Obstet Gynecol 100:864–868
McClucas B, Adler L, Perrella R. (2001) Uterine fibroid embolization: non-surgical treatment for symptomatic fibroids. J Am Coll Surg 192:95–105
Ravina JH, Aymard A, Ciraru-Viqneron N, et al. (2000) Arterial embolization of uterine myoma: results apropos of 286 cases. J Gynecol Obstet Biol Reprod (Paris) 29:272–275
Spies JB, Ascher SA, Roth AR, et al. (2001) Uterine artery embolization for leiomyomata. Obstet Gynecol 98:29–34
Walker WJ, Pelage JP. (2002) Uterine artery embolisation for symptomatic fibroids: clinical results in 400 women with imaging follow-up. BJOG 109:1262–1272
Worthington-Kirsch RL, Popky GL, Hutchins FL Jr (1998) Uterine arterial embolization for the management of leiomyomas: quality-of-life assessment and clinical response. Radiology 208:625–629
Hwang GI, Razavi MK, Chen BH (2001) A single-center study comparing abdominal myomectomy with uterine artery embolization for treatment of myomas [Abstract]. Obstet Gynecol 97 (4 Suppl 1):S7
Pinto I, Chimeno P, Romo A, et al. (2003) Uterine fibroids: uterine artery embolization versus abdominal hysterectomy for treatment—a prospective, randomized, and controlled clinical trial. Radiology 226:425–431
Mann P New studies show embolisation better treatment option for uterine fibroids. PR Newswire. Accessible at http://www.prnewswire.co.uk/newsindex.shtml?/cgi/news/release?id=181258
Hehenkamp WJ, Volkers NA, Donderwinkel PF, et al. (2005) Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids (EMMY trial): peri and postprocedural results from a randomized controlled trial. Am J Obstet Gynecol 193:1618–1629
Spies JB (2006) The Emmy trial of uterine artery embolization for the treatment of symptomatic uterine fibroid tumors: randomized, yes, but a flawed trial nonetheless. J Vasc Interv Radiol 17:413–415
Siskin GP Uterine fibroid embolization. Accessible at http://www.emedicine.com/radio/topic837.htm
Bradley EA, Reidy JF, Forman RG, et al. (1998) Transcatheter uterine artery embolization to treat large uterine fibroids. Br J Obstet Gynaecol 105:235–240
Cura M, Cura A, Buqnone A (2006) Role of magnetic resonance imaging n patient selection for uterine artery embolization. Acta Radiol 47:1105–1114
Harman M, Zeteroglu S, Arslan H, et al. (2006) Predictive value of magnetic resonance imaging signal and contrast-enhancement characteristics on post-embolization volume reduction of uterine fibroids. Acta Radiol 47:427–35
Siskin GP, Stainken BF, Dowling K, et al. (2000) Outpatient uterine artery embolization for symptomatic uterine fibroids: experience in 49 patients. J Vasc Interv Radiol 11:305–311
Klein A, Schwartz ML (2001) Uterine artery embolization for the treatment of uterine fibroids: an outpatient procedure. Am J Obstet Gynecol 184:1556–1563
Chrisman HB, West D, Corpuz B, et al. (2005) Primary failure of uterine artery embolization: use of magnetic resonance imaging to select patients for repeated embolization. J Vasc Interv Radiol 16:1143–1147
Price N, Gillmer MD, Stock A, et al. (2005) Pregnancy following uterine artery embolisation. J Obstet Gynaecol 25:28–31
Goldberg J. (2005) Pregnancy after uterine artery embolization for leiomyomata: the Ontario Multicenter Trial. Obstet Gynecol 106:195–196
Carpenter TT, Walker WJ. (2005) Pregnancy following uterine artery embolisation for symptomatic fibroids: a series of 26 completed pregnancies. BJOG 112:321–325
Goodwin SC, Bonilla SC, Sacks D, et al. (2003) Reporting standards for uterine artery embolization for the treatment of uterine leiomyomata. J Vasc Intervent Radiol 14:S467–S476
Ghai S, Rajan DK, Benjamin MS, et al. (2005) Uterine artery embolization for leiomyomas: pre- and postprocedure evaluation with US. Radiographics 25:1159–1172
Nikolic, et al. (2000) Patient radiation dose associated with uterine artery embolization. Radiology 214:121–125
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Morris, C.S. Update on uterine artery embolization for symptomatic fibroid disease (uterine artery embolization). Abdom Imaging 33, 104–111 (2008). https://doi.org/10.1007/s00261-007-9187-3
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DOI: https://doi.org/10.1007/s00261-007-9187-3