Utility of nonselective abdominal aortography in demonstrating ovarian artery collaterals in patients undergoing uterine artery embolization for fibroids
Ca. Binkert et al., Utility of nonselective abdominal aortography in demonstrating ovarian artery collaterals in patients undergoing uterine artery embolization for fibroids, J VAS INT R, 12(7), 2001, pp. 841-845
PURPOSE: To review the incidence of ovarian collateral supply to uterine fi
broids as demonstrated by nonselective abdominal aortography before uterine
artery embolization (UAE) and to evaluate the effect of such visualization
on interventional management.
MATERIALS AND METHODS: The aortograms of 51 consecutive patients (mean age,
42.4 y; range, 30-53 y) undergoing UAE for symptomatic uterine fibroids we
re reviewed retrospectively for the visualization of ovarian arteries exten
ding into the pelvis. If ovarian arteries were visualized, their size relat
ive to the ipsilateral external iliac artery was measured. Arteries believe
d large enough to represent a significant blood supply to the uterine fibro
ids were further evaluated after UAE to determine whether flow persisted.
RESULTS: In 13 of 51 patients (25%), a total of 18 ovarian arteries were id
entified. They were bilateral in five patients and unilateral in eight. The
ir sizes relative to the ipsilateral external iliac artery ranged from 8% t
o 57% (mean, 26%). Eight ovarian arteries with a relative size greater than
or equal to 25% were further evaluated. Five of the eight (62.5%) were not
visible after UAE. Of the three persistent ovarian collateral arteries, tw
o were successfully embolized. The patient with the untreated collateral ar
tery experienced persistent menorrhagia.
CONCLUSION: Preembolization aortography with the catheter tip at level of t
he renal arteries demonstrated ovarian collateral arteries in 25% of patien
ts with uterine fibroids. However, their detection influenced treatment in
only 6% of the reported cases.