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《Journal of vascular and interventional radiology : JVIR》2014,25(6):823-832
PurposeTo assess the efficacy of two embolic agents in the treatment of symptomatic uterine leiomyomas.Materials and MethodsA randomized, prospective, single-center study enrolled 60 women with symptomatic uterine leiomyomas. Uterine artery embolization (UAE) with spherical polyvinyl alcohol (SPVA) microspheres (n = 30; 700–900 μm and 900–1,200 μm; near-stasis or stasis endpoint) and tris-acryl gelatin (TAG) microspheres (n = 30; 500–700 μm; “pruned-tree” endpoint) was performed. Infarction rates were calculated for the dominant tumor and for small (< 2 cm) and large (> 2 cm) nondominant tumors. The primary endpoint was tumor infarction at 24 hours measured by contrast-enhanced magnetic resonance imaging assessed by a blinded reviewer.ResultsBaseline characteristics were similar between groups. The primary endpoint was similar in both treatments (≥ 91% dominant tumor infarction; SPVA. 86.2%; TAG, 93.3%, P = .35). Complete infarction (100%) was also similar between arms at 24 hours and 3 months. Symptom severity was reduced and quality of life improved equally at 3 and 12 months in each treatment group. Complications were minor in both groups.ConclusionsUterine leiomyoma infarction at 24 hours and 3 months after treatment with SPVA or TAG microspheres was comparable when using near-stasis as a procedural endpoint with SPVA microspheres. Symptom relief was maintained for as long as 12 months for both embolic agents. 相似文献
3.
Katsumori T Kasahara T Kin Y Ichihashi S 《Cardiovascular and interventional radiology》2007,30(3):398-404
Purpose To assess uterine artery recanalization, together with tumor devascularization, after embolization using gelatin sponge particles
alone for fibroids.
Methods Twenty-seven patients underwent uterine artery embolization (UAE) for fibroids using only gelatin sponge particles. The angiographic
endpoint of embolization was defined as near stasis of contrast medium in the ascending segment of the uterine artery. All
patients underwent contrast-enhanced magnetic resonance angiography (MRA) before and 4 months after UAE, and contrast-enhanced
magnetic resonance imaging (CE-MRI) before, 1 week after, and 4 months after UAE. The visualization of the uterine arteries
before and 4 months after UAE was assessed using MRA. The infarction rates of the largest tumor were assessed using CE-MRI
1 week after UAE.
Results MRA 4 months after UAE showed 100% (53/53) of the descending and transverse segments, and 88% (43/49) of the ascending segments
that had been noted on baseline MRA. The visualization of the ascending segments on MRA 4 months after UAE was identical to
that on baseline MRA in 20 of 27 patients (74%). CE-MRI showed complete infarction of the largest tumor in 22 of 27 patients
(81%), and 90–99% infarction of the largest tumor in the remaining 5 of 27 patients (19%).
Conclusion Based on the MR study, in most cases uterine artery recanalization occurred, together with sufficient devascularization of
fibroids, after UAE using gelatin sponge particles alone. 相似文献
4.
Trisacryl Gelatin Microspheres Versus Polyvinyl Alcohol Particles in the Preoperative Embolization of Bone Neoplasms 总被引:2,自引:0,他引:2
Basile A Rand T Lomoschitz F Toma C Lupattelli T Kettenbach J Lammer J 《Cardiovascular and interventional radiology》2004,27(5):495-502
The aim of this study was to compare the efficacy of trisacryl gelatin microspheres versus polyvinyl alcohol particles (PVA) in the preoperative embolization of bone neoplasms, on the basis of intraoperative blood loss quantified by the differences in preoperative and postoperative hematic levels of hemoglobin, hematocrit and erythrocytes count. From January 1997 to December 2002, preoperative embolization of bone tumors (either primary or secondary) was carried out in 49 patients (age range 12/78), 20 of whom were treated with trysacril gelatin microspheres (group A) and 29 with PVA particles (group B). The delay between embolization and surgery ranged from 1 to 13 days in group A and 1 to 4 days in group B. As used in international protocols, we considered hematic levels of hemoglobin, hematocrit and erythrocytes count for the measurement of intraoperative blood loss then the differences in pre- and postoperative levels were used as statistical comparative parameters. We compared the values of patients treated with embospheres (n = 10) and PVA (n = 18) alone, and patients treated with (group A = 10; group B = 11) versus patients treated without other additional embolic materials in each group (group A = 10; group B = 18). According to the Students t-test (p < 0.05), the difference of hematic parameters between patients treated by embospheres and PVA alone were significant; otherwise there was no significant difference between patients treated with only one embolic material (embospheres and PVA) versus those treated with other additional embolic agents in each group. The patients treated with microspheres had a minor quantification of intraoperative blood loss compared to those who received PVA particles. Furthermore, they had a minor increase of bleeding related to the delay time between embolization and surgery. The use of additional embolic material did not improve the efficacy of the procedure in either group of patients. 相似文献
5.
Alexandre Laurent Michel Wassef Julien Namur Homayra Ghegediban Jean-Pierre Pelage 《Cardiovascular and interventional radiology》2010,33(5):995-1000
The purpose of this study was to compare, after embolization, the distribution in the uterine arterial vasculature of tris-acryl
gelatin microspheres (TGMS) and polyvinyl alcohol microspheres (PVAMS). A limited bilateral uterine artery embolization was
performed in six adult sheep under fluoroscopic control by injecting in each uterine artery 0.25 ml of 500- to 700-μm TGMS
of PVAMS suspended in 50/50 saline/contrast medium. Sacrifices were performed 1 week after embolization and uteri were analyzed
histologically. The number and size of microspheres and vessels were measured, as well as the histological location according
to a classification in four zones of the uterus. One hundred sixty-five vessels (69 vessels occluded with TGMS and 96 vessels
occluded with PVAMS) were measured. The size of the occluded vessels decreased significantly from proximal to distal zones
of the uterine vasculature (P < 0.0001). The location of TGMS and PVAMS within the vasculature was significantly different (P < 0.0001) since PVAMS blocked significantly more distally than TGMS. Deformation of the microspheres within the tissue was
greater for PVAMS (18.0% ± 12.3%) than for TGMS (8.7% ± 9.2%) (P < 0.0001). In conclusion, PVAMS have a more distal distribution in the sheep uterine vasculature, compared to TGMS. Such
differences in partition, already described in the kidney embolization model, can ultimately explain the different clinical
outcome reported with these two types of microspheres in uterine fibroid embolization. 相似文献
6.
Uterine artery embolization (UAE) for the treatment of symptomatic leiomyomata has shown excellent short-term clinical efficacy
and minimal complications, yet recurrences after successful treatments at mid- and long-term follow-up have been reported.
Exact etiologies for such recurrences have not been fully understood. We present a case of symptom recurrence with the development
of a hypertrophic ovarian artery after successful UAE with polyvinyl alcohol particles, successfully treated with ovarian
and repeat UAEs. 相似文献
7.
Worthington-Kirsch RL Siskin GP Hegener P Chesnick R 《Cardiovascular and interventional radiology》2011,34(3):493-501
Objective
To evaluate the efficacy of acrylamido polyvinyl alcohol microspheres (a-PVAM) as an embolic agent for uterine artery embolization (UAE) compared with Tris-acryl gelatin microspheres (TAGM). 相似文献8.
Prospective Study of Elective Bilateral Versus Unilateral Femoral Arterial Puncture for Uterine Artery Embolization 总被引:2,自引:0,他引:2
Bratby MJ Ramachandran N Sheppard N Kyriou J Munneke GM Belli AM 《Cardiovascular and interventional radiology》2007,30(6):1139-1143
The purpose of this study was to assess the effect of elective bilateral femoral arterial punctures for uterine artery embolization
(UAE) of symptomatic fibroids on fluoroscopy and procedural time, patient dose, and ease of procedure. We conducted a prospective
study of UAE with either the intention to catheterize both uterine arteries using a single femoral puncture (n = 12) or elective bilateral arterial punctures from the outset (n = 12). The same two operators undertook each case. Main outcome measures were total procedure time, fluoroscopy time, dose-area
product (DAP), and total skin dose. A simulation was then performed on an anthropomorphic phantom using the mean in vivo fluoroscopy
parameters to estimate the ovarian dose. Bilateral UAE was achieved in all patients. None of the patients with initial unilateral
arterial puncture required further contralateral arterial puncture. The mean fluoroscopy time in the group with elective bilateral
punctures was 12.8 min, compared with a mean of 16.6 min in patients with unilateral puncture (p = 0.046). There was no significant difference in overall procedure time (p = 0.68). No puncture-site complications were found. Additional catheters were required only following unilateral puncture. The
simulated dose was 25% higher with unilateral puncture. Although there was no significant difference in measured in vivo patient
dose between the two groups (DAP, p = 0.32), this is likely to reflect the wide variation in other patient characteristics. Allowing for the small study size, our
results show that the use of elective bilateral arterial punctures reduces fluoroscopy time, requires less catheter manipulation,
and, according to the simulation model, has the potential to reduce patient dose. The overall procedure time, however, is
not significantly reduced. 相似文献
9.
Objective
This study was designed to establish guinea pigs as an animal model for uterine artery embolization (UAE) with tris-acryl gelatin microspheres (TAGM).Methods
Twenty-five female adult guinea pigs were randomly divided into two groups, including a uterine artery casting mould group (n = 10) and a UAE group (n = 15). Pelvic angiography and vascular casting mould were performed in the first group. The anatomical characters of the pelvic cavity in guinea pigs were described. In the second group, the technical feasibility of performing UAE with TAGM in guinea pigs was investigated. The histopathological slides of the uterus of guinea pigs after UAE were examined to inspect the outcomes of UAE.Results
The uterine artery springs from the internal iliac artery, ascends tortuously along the cervix, and gives off vertically 8–10 branches to the cervix uteri and uterine horns. The diameters of the trunk of the uterine artery and its first branch were 0.32 ± 0.027 mm and 0.14 ± 0.01 mm, respectively. For UAE animals, the dosages of 40–120 and 100–300 μm TAGM were 0.033 ± 0.003 ml and 0.015 ± 0.002 ml, respectively. On histopathological slides, embosphere particles were found in the first branches of the uterine artery, the subserous arteries, and the intramural arteries. Inflammatory reactions in the uterus were common in guinea pigs after UAE. Local or dispersed areas of necrosis in uterus also were observed in a few guinea pigs.Conclusions
Guinea pigs are an appropriate and feasible model for UAE with TAGM. 相似文献10.
真丝线段和聚己烯己醇海绵在子宫肌瘤栓塞术的应用研究 总被引:3,自引:0,他引:3
目的评价真丝线段和聚己烯己醇海绵(PVA)在子宫肌瘤栓塞术的临床应用价值.材料和方法73例子宫肌瘤,行选择性双侧子宫动脉插管造影,明确子宫肌瘤血供后,分别采用真丝线段(25例)和PVA(48例)栓塞子宫动脉.结果术后6个月,98.33%月经量恢复正常,肌瘤体积缩小56.05%(p<0.01),真丝线段组与PVA组无显著差异(p>0.05);真丝线段组复发率8%,PVA组无复发,两者差异不显著(p>0.05).不良反应包括缺血性盆腔疼痛、发热等,经对症治疗后缓解,真丝线段组发热的发生率高于PVA组(p<0.05);无并发症.结论子宫肌瘤栓塞术安全、有效.真丝线段和PVA均能取得满意的临床疗效,PVA值得推荐使用. 相似文献
11.
Murat Bülent Küçükay Fahrettin Küçükay 《Journal of vascular and interventional radiology : JVIR》2021,32(6):819-825
PurposeTo evaluate the safety and efficacy of superior rectal artery embolization (SRAE) with different-sized tris-acryl gelatin microspheres in symptomatic hemorrhoidal disease (HD).Materials and MethodsForty-two patients (male, 30; female, 12; median age, 45 years) with symptomatic HD (2 grade I, 8 grade II, 17 grade III, and 15 grade IV) were divided into 3 experimental arms (500–700 μm, 700–900 μm, and 900–1,200 μm groups; each had 14 patients) in a prospective randomized style to perform SRAE. Follow-up was performed by rectoscopy, clinical examination, and questionnaires. The primary outcome measure was the clinical success rate at 12 months. Secondary outcome measures were technical success rate, recurrence rate, procedure-related mortality, procedure-related complications, and any outcome changes between particle sizes.ResultsNo procedure-related deaths or major morbidities were observed. There was a 54% minor complication rate (n = 23/42) in the treated zone: 45% sustained small superficial ulcerations (n = 19/42), 7% small rectosigmoid junction ulcerations (n = 3/42), and 2% small fibrotic scar tissue (n = 1/42). The clinical success rate was 93%. Of the groups, the best French bleeding score decrease was obtained in the 900–1,200 μm group. There were improvements in the quality of life score and visual analogue scale score after the SRAE procedure, although not in the Goligher score. No recurrent disease was observed.ConclusionsSRAE with tris-acryl gelatin microspheres for symptomatic HD is a safe and efficient treatment, with results favoring the use of larger microspheres. 相似文献
12.
Stevo Duvnjak Pernille Ravn Anders Green Poul Erik Andersen 《Cardiovascular and interventional radiology》2016,39(2):204-209
Purpose
This study was designed to evaluate the long-term clinical outcome and frequency of reinterventions in patients with uterine fibroids treated with embolization at a single center using polyvinyl alcohol microparticles.Methods
The study included all patients with symptomatic uterine fibroids treated with uterine fibroid embolization (UFE) with spherical (s-PVA) and nonspherical (ns-PVA) polyvinyl alcohol microparticles during the period January 2001 to January 2011. Clinical success and secondary interventions were examined. Hospital records were reviewed during follow-up, and symptom-specific questionnaires were sent to all patients.Results
In total, 515 patients were treated with UFE and 350 patients (67 %) were available for long-term clinical follow-up. Median time of follow-up was 93 (range 76–120.2) months. Eighty-five patients (72 %) had no reinterventions during follow-up in the group embolized with ns-PVA compared with 134 patients (58 %) treated with s-PVA. Thirty-three patients (28 %) underwent secondary interventions in the ns-PVA group compared with 98 patients (42 %) in s-PVA group (χ 2 test, p < 0.01).Conclusions
Spherical PVA particles 500–700 µm showed high reintervention rate at long-term follow-up, and almost one quarter of the patients underwent secondary interventions, suggesting that this type of particle is inappropriate for UFE.13.
子宫肌瘤栓塞术中子宫动脉卵巢支的显示及其意义 总被引:3,自引:0,他引:3
目的 研究子宫肌瘤动脉栓塞治疗时 ,卵巢支显示与卵巢功能改变的关系。资料与方法 对 2 5 3例行动脉栓塞治疗子宫肌瘤患者进行回顾性研究 ,统计子宫动脉卵巢支显示类型 ,比较不同显示类型与发生停经、闭经的关系。结果 子宫动脉造影时 ,196例未显示卵巢血管 ,其中有 4例治疗后发生停经或闭经 ,5 7例显示卵巢血管 ,其中 5例发生停经或闭经。两者比较有显著性差异 (χ2 =4 .0 4 ,P <0 .0 5 )。结论 子宫动脉造影卵巢支显示的患者 ,卵巢功能可能易受影响 ,表现为发生停经或闭经者较多 相似文献
14.
Purpose: To determine whether uterine fibroid embolization (UFE) with polyvinyl alcohol (PVA) particles affects fertility in women
desiring future pregnancy.
Methods: Of 288 patients managed with UFE with PVA particles for uterine myoma or adenomyosis between 1998 and 2001, 94 patients were
enrolled in this study. The age range of participants was 20–40 years. The data were collected through review of medical records
and telephone interviews. Mean duration of follow-up duration was 35 months (range 22–60 months). Patients using contraception
and single women were excluded, and the chance of infertility caused by possible spousal infertility or other factors was
disregarded. Contrast-enhanced magnetic resonance imaging was performed in all patients before and after UFE, and the size
of PVA particles used was 255–700 μm.
Results: Among 94 patients who underwent UFE with PVA, 74 were on contraceptives, 6 had been single until the point of interview, and
8 were lost to follow-up. Of the remaining 6 patients who desired future pregnancy, 5 (83%) succeeded in becoming pregnant
(1 patient became pregnant twice). Of a total of 8 pregnancies, 6 were planned pregnancies and 2 occurred after contraception
failed. Five deliveries were vaginal, and 2 were by elective cesarean. Artificial abortion was performed in 1 case of unplanned
pregnancy. There was 1 case of premature rupture of membrane (PROM) followed by preterm labor and delivery of an infant who
was small-for-gestational-age. After UFE, mean volume reduction rates of the uterus and fibroid were 36.6% (range 0 to 62.6%)
and 69.3% (range 36.3% to 93.3%), respectively.
Conclusion: Although the absolute number of cases was small, UFE with PVA particles ultimately did not affect fertility in the women who
underwent the procedure. 相似文献
15.
Bronchial Artery Embolization for Life-Threatening Hemoptysis Using Tris-Acryl Microspheres: Short-Term Result 总被引:5,自引:2,他引:3
Corr PD 《Cardiovascular and interventional radiology》2005,28(4):439-441
A prospective study of 70 patients with life-threatening hemoptysis who had bronchial and systemic artery embolization with tris-acryl linked microspheres was performed over 15 months. The procedure was technically successful in 90% of patients and at 24 hr after the procedure (87%). Recurrent hemoptysis occurred in 13% of patients within the first week. Chest pain was experienced following embolization in 7% of patients. The mortality was 10% due to the inclusion of patients with pulmonary metastases. Bronchial artery embolization using microspheres is an effective and well-tolerated treatment for patients with life-threatening hemoptysis who are not surgical candidates. 相似文献
16.
Purpose To retrospectively evaluate the relationship between the degree of infarction of uterine fibroids on enhanced MRI after embolization
and long-term clinical outcomes.
Methods During 92 months, 290 consecutive patients with symptomatic uterine fibroids were treated with embolization; 221 who underwent
enhanced MRI before embolization and 1 week after embolization were included in this study. The infarction rates of all fibroid
tissue were assessed using enhanced MRI after embolization. Patients were divided into three groups according to the infarction
rates: group A (100% infarction, n = 142), group B (90–99% infarction, n = 74), group C (<90% infarction, n = 5). The cumulative rates of clinical outcomes were compared among groups using the Kaplan-Meier limited method.
Results Group A had a significantly higher rate of symptom control than groups B and C. The cumulative rates of symptom control at
5 years were 93%, 71%, and 60% in groups A, B, and C, respectively. Group A had a significantly lower rate of gynecologic
intervention after embolization than groups B and C. The cumulative rates of additional gynecologic intervention at 5 years
were 3%, 15%, and 20% in groups A, B, and C, respectively.
Conclusions The degree of infarction of uterine fibroids after embolization on enhanced MRI was related to long-term clinical outcomes.
Complete infarction of all fibroid tissue can induce a higher rate of symptom control, with a lower rate of additional gynecologic
intervention in the long term compared with incomplete infarction of fibroid tissue. 相似文献
17.
Hehenkamp WJ Volkers NA Bartholomeus W de Blok S Birnie E Reekers JA Ankum WM 《Cardiovascular and interventional radiology》2007,30(5):866-875
In this paper the effect of uterine artery embolization (UAE) on sexual functioning and body image is investigated in a randomized
comparison to hysterectomy for symptomatic uterine fibroids. The EMbolization versus hysterectoMY (EMMY) trial is a randomized
controlled study, conducted at 28 Dutch hospitals. Patients were allocated hysterectomy (n = 89) or UAE (n = 88). Two validated questionnaires (the Sexual Activity Questionnaire [SAQ] and the Body Image Scale [BIS]) were completed
by all patients at baseline, 6 weeks, and 6, 12, 18, and 24 months after treatment. Repeated measurements on SAQ scores revealed
no differences between the groups. There was a trend toward improved sexual function in both groups at 2 years, although this
failed to reach statistical significance except for the dimensions discomfort and habit in the UAE arm. Overall quality of
sexual life deteriorated in a minority of cases at all time points, with no significant differences between the groups (at
24 months: UAE, 29.3%, versus hysterectomy, 23.5%; p = 0.32). At 24 months the BIS score had improved in both groups compared to baseline, but the change was only significant
in the UAE group (p = 0.009). In conclusion, at 24 months no differences in sexuality and body image were observed between the UAE and the hysterectomy
group. On average, both after UAE and hysterectomy sexual functioning and body image scores improved, but significantly so
only after UAE.
Trial
registration: www.clinicaltrials.com (identifier: NCT00100191). All centers where the trial was conducted, other than those below, are listed
in the Acknowledgments. 相似文献
18.
Purpose Bilateral uterine artery embolization (UAE) is considered necessary to provide effective treatment for symptomatic uterine
fibroids. Occasionally, only unilateral embolization is performed, and this study evaluates these outcomes.
Materials and Methods As part of a prospective observational study of more than 1600 patients treated with UAE since 1996, there have been 48 patients
in whom unilateral embolization has been performed. This study retrospectively reviews clinical response as assessed by our
standard questionnaire and radiological response assessed by either magnetic resonance imaging or ultrasound.
Results Two principal groups emerged: the largest, where only the dominant unilateral arterial supply was electively embolized (30
patients); and the second, where there was technical failure to catheterize the second uterine artery as a result of anatomical
constraints (12 patients). Favorable clinical response with a reduction in menorrhagia at 1 year was seen in 85.7% (18/21)
of those patients with a dominant arterial supply to the fibroid(s). In contrast, in those patients where there was technical
failure to embolize one uterine artery, there was a high rate of clinical failure requiring further intervention in 58.3%
(7/12). Comparison of the technical failure group with the dominant uterine artery group demonstrated a statistically significant
(Fisher’s exact test) difference in the proportion of patients with evidence of persistent fibroid vascularity (p < 0.001) and requiring repeat intervention (p < 0.01).
Conclusion We conclude that unilateral UAE can achieve a positive clinical result in the group of patients where there is a dominant
unilateral artery supplying the fibroid(s), in contrast to the poor results seen following technical failure. 相似文献
19.
Tetsuya Katsumori Toshiyuki Kasahara Minori Oda Tomoya Kotani 《Cardiovascular and interventional radiology》2011,34(3):513-521
The purpose of this study was to prospectively assess the safety and effectiveness of uterine artery embolization (UAE) using
porous gelatin particle (PGP; Gelpart; Asuterasu, Tokyo, Japan) for symptomatic uterine fibroids. Twenty-five consecutive
premenopausal women underwent UAE with PGP. The angiographic end point of embolization was near stasis of the ascending uterine
artery. Pelvic magnetic resonance imaging (MRI) was obtained before and after the procedure. Complications were assessed.
The outcomes of technique, infarction rates of all fibroid tissue after UAE with contrast-enhanced MRI, change in symptoms
and quality of life using serial Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaires, and additional interventions
were evaluated. Bilateral UAE was successfully performed in all patients. Enhanced MRI 1 week after UAE showed that 100% infarction
of all fibroid tissue was achieved in 65% (15 of 23) of patients; 90–99% infarction was achieved in 35% (8 of 23) of patients.
Mean follow-up was 12 months (range 1–20). Symptom and QOL scores at baseline were 47.2 and 61.7, respectively. Both scores
significantly improved to 26.3 (P < 0.001) and 82.4 (P < 0.001) at 4 months and to 20.4 (P < 0.001) and 77.6 (P < 0.001) at 1 year, respectively. No additional gynecologic interventions were performed in any patient. There were no major
complications. Minor complications occurred in two patients. UAE using PGP is a safe and effective procedure and shows that
outcomes after UAE, as measured with enhanced MRI and UFS-QOL questionnaires, seem comparable with those of UAE using other
embolic agents. PGP is a promising embolic agent used for UAE to treat symptomatic uterine fibroids. Further comparative study
between PGP and other established embolic agents is required. 相似文献
20.
This case series examines the safety and efficacy of uterine artery embolization (UAE) in the treatment of obstructive nephropathy
caused by large fibroids. Between 2004 and 2007, 10 patients referred with symptomatic uterine fibroids that were found to
be causing either unilateral (7 patients) or bilateral (3 patients) hydronephrosis were treated by UAE. Presenting complaints
included menorrhagia, dysmenorrhea, bulk symptoms, loin pain, postobstructive atrophy, and mild renal impairment. All had
posterior intramural dominant fibroids >11 cm in maximum sagittal diameter and uterine volumes between 3776 and 15,625 ml.
Outcome measures at between 12 and 36 months included procedural success, repeat intervention, relief of symptoms, resolution
of hydronephrosis, stable renal function and size, and avoidance of hysterectomy. In all cases the cause of renal obstruction
was confirmed to be a giant fibroid compressing the ureter at the pelvic brim. In all cases UAE was technically successful,
though two patients required a repeat procedure. In eight patients hydronephrosis resolved and the obstruction was relieved,
though two still had some bulk symptoms not requiring further treatment. Renal function improved or was stable in all cases.
Renal size was stable in all cases. Where menorrhagia was part of the symptom complex it was relieved in all cases. Two patients
diagnosed as having postobstructive atrophy of one kidney underwent retrograde ureteric stenting on the nonatrophied side
prior to UAE. This was unsuccessful in one of the cases due to the distortion caused by the fibroid. Despite improvement in
hydronephrosis this patient underwent hysterectomy at 7 months after a renogram demonstrated persistent obstruction at the
pelvic brim. In the second patient a double pigtail stent was inserted with difficulty and eventually removed at 8 months.
This patient has had stable renal function and size for 3 years post-UAE. We conclude that UAE is safe and effective in treating
patients with obstructive hydronephrosis caused by large fibroids. 相似文献