Authors
Politova A.K., Bolomatov N.V., Bruslik S.V., Slabozhankina E.A., Sviridova T.I. Amelina Yu.L.
Pirogov National Medical and Surgical Center, Moscow
Abstract
Surgery for endovascular embolization of the uterine arteries (UAE) for uterine myoma has a number of disadvantages. Having analyzed the pathophysiology and complications of UAE, our research group proposed a technique for superselective embolization of uterine fibroids arteries. Considering the locality of embolization, we called this technique “sniper” technology for embolization of uterine fibroids (MM).
Purpose of the study. To evaluate the immediate results of superselective arterial embolization of vessels of myomatous nodes in uterine myoma.
Material and methods. The study included 132 patients with a diagnosis of MM, who underwent 133 operations. Age 42.8±5.7 (from 32 to 57 years old). All patients underwent embolization of arteries feeding the myomatous node of the MM using microcatheter technique. In order to assess the effectiveness of MM occlusion, transvaginal ultrasound with Doppler ultrasound was performed before the operation and the next day after the operation, before the patient was discharged and 14, 30 days after the operation.
Results. The following were used as arterial approaches for UAE: radial — 75 (56.3%); shoulder — 52 (39.0%); femoral approach — 5 (3.7%). In 19 (14.2%) patients, UAE of only one artery was performed. The absence of blood flow in the myomatous nodes with its contraction in the uterine and ovarian arteries was in 132 (100%) patients.
Conclusions. 1. Method of arterial superselective embolization of myomatous nodes of the uterus is an effective and safe method of treatment. 2. The method of superselective arterial embolization of myomatous nodes of the uterus needs additional research.
Keywords: uterine fibroids, fibroids, superselective, embolization, sniper, polyvinyl alcohol, microspheres, microcatheter.
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