Sc. Goodwin et al., PRELIMINARY EXPERIENCE WITH UTERINE ARTERY EMBOLIZATION FOR UTERINE FIBROIDS, Journal of vascular and interventional radiology, 8(4), 1997, pp. 517-526
PURPOSE: To evaluate the potential usefulness of transcatheter uterine
artery embolization as a treatment for fibroid-related vaginal bleedi
ng and pelvic pain refractory to hormonal therapy and myomectomy. MATE
RIALS AND METHODS: Eleven patients (aged 27-55 years; mean, 44.2 years
; none desiring future pregnancy) with refractory vaginal bleeding and
/or chronic pelvic pain related to uterine leiomyomata underwent uteri
ne artery embolization with use of polyvinyl alcohol (PVA) particles,
Clinical improvement was assessed by detailed questionnaire at 2-9 mon
ths (mean, 5.8 months) after the procedure, Sonographic measurements o
f the uterus and dominant masses were obtained before and at 2 months
after the procedure. RESULTS: All 11 patients underwent technically su
ccessful embolization, Eight of nine women who completed the follow-up
questionnaire reported noticeable symptomatic improvement, including
three women with complete resolution of symptoms, One woman (the only
patient undergoing unilateral embolization) exhibited no clinical resp
onse, Another patient developed endometritis and pyometra 3 weeks afte
r the procedure, necessitating hysterectomy, Large reductions in uteri
ne volume (average, 40%) and dominant fibroid size (average, 60%-65%)
were sonographically demonstrated, CONCLUSION: Uterine artery emboliza
tion represents a promising new method of treating fibroid-related men
orrhagia and pelvic pain, Further investigation will be required to as
sess clinical response and durability, identify appropriate candidates
, and define the optimal angiographic technique and PVA particle size.