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Uterine artery embolization for leioyomas, ultrasonography and angiography aspects.

Horhoianu IA, Horhoianu VV, Joita D, Carstoiu M, Dorobat B - J Med Life (2012)

Bottom Line: Regarding the uterus, its volume evolution registered a descending trend, the mean decrease at 30 days being of 25% (-81,6 cm³) and at 90 days of 52%(-173,15 cm³).The mean global reduction at 30 days was of 44% (-33,18 cm³) and of 62% (-60,85 cm³) at 90 days.Longer evaluation time is needed for an accurate evaluation of volume reduction degree.

View Article: PubMed Central - PubMed

Affiliation: Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. irinah7@gmail.com

ABSTRACT

Objective and rationale: The purpose of this study is to evaluate the degree of fibroid shrinkage which well correlates with symptom regression, and thus to assess the effectiveness of the procedure.

Method: 31 patients were included in the trial after selection. All the patients were thoroughly evaluated before embolization, the following day and at a month after but also at 3 months for 10 of them. A certain protocol was followed passing through well established steps. The purpose was to discover and rule out any associated possible disease and to assess and grade the symptoms, ultrasound and angiographic aspects.

Results: Regarding the uterus, its volume evolution registered a descending trend, the mean decrease at 30 days being of 25% (-81,6 cm³) and at 90 days of 52%(-173,15 cm³). The fibroids also decreased statistically, the mean global variation at 30 days registering a decrease of -17,66 cm³(27%) and 61% at day 90. The mean global reduction at 30 days was of 44% (-33,18 cm³) and of 62% (-60,85 cm³) at 90 days. Absence of uterine anastomoses lead to proper fibroid decrease whereas their presence diminished the chances.

Conclusions: The uterine and fibroid volumes registered a statistical volume decrease at 30 and 90 days in comparison with the volumes before embolization. Absence of uterine anastomoses led to proper fibroid decrease. Longer evaluation time is needed for an accurate evaluation of volume reduction degree.

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Volume- Uterine and fibroma decrease
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Figure 4: Volume- Uterine and fibroma decrease

Mentions: We found such connections to be present in 58% of cases, 18 out of 31 patients. These were found before and or after particle injection stating a reflux from the uterine to the ovarian circulation. We decided to classify them into 3 types: indirect, direct, (the first communicating with the ovarian artery through ovarian anastomoses and the latter having a direct connection to the ovarian artery, appearing before particle injection) and reflux anastomoses (appearing after particle injection at the embolization endpoint). Unfortunately, lack of anastomoses does not necessarily mean their inexistence, possible vasospasm being a potential explanation for their hiding. After statistical analysis we concluded that a lack of such anastomoses led to fibroid reduction, whereas their presence assured growth in 56% of cases an shrinkage in 44%.(chi-square test p=0,009) (Fig. 4).


Uterine artery embolization for leioyomas, ultrasonography and angiography aspects.

Horhoianu IA, Horhoianu VV, Joita D, Carstoiu M, Dorobat B - J Med Life (2012)

Volume- Uterine and fibroma decrease
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3539832&req=5

Figure 4: Volume- Uterine and fibroma decrease
Mentions: We found such connections to be present in 58% of cases, 18 out of 31 patients. These were found before and or after particle injection stating a reflux from the uterine to the ovarian circulation. We decided to classify them into 3 types: indirect, direct, (the first communicating with the ovarian artery through ovarian anastomoses and the latter having a direct connection to the ovarian artery, appearing before particle injection) and reflux anastomoses (appearing after particle injection at the embolization endpoint). Unfortunately, lack of anastomoses does not necessarily mean their inexistence, possible vasospasm being a potential explanation for their hiding. After statistical analysis we concluded that a lack of such anastomoses led to fibroid reduction, whereas their presence assured growth in 56% of cases an shrinkage in 44%.(chi-square test p=0,009) (Fig. 4).

Bottom Line: Regarding the uterus, its volume evolution registered a descending trend, the mean decrease at 30 days being of 25% (-81,6 cm³) and at 90 days of 52%(-173,15 cm³).The mean global reduction at 30 days was of 44% (-33,18 cm³) and of 62% (-60,85 cm³) at 90 days.Longer evaluation time is needed for an accurate evaluation of volume reduction degree.

View Article: PubMed Central - PubMed

Affiliation: Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. irinah7@gmail.com

ABSTRACT

Objective and rationale: The purpose of this study is to evaluate the degree of fibroid shrinkage which well correlates with symptom regression, and thus to assess the effectiveness of the procedure.

Method: 31 patients were included in the trial after selection. All the patients were thoroughly evaluated before embolization, the following day and at a month after but also at 3 months for 10 of them. A certain protocol was followed passing through well established steps. The purpose was to discover and rule out any associated possible disease and to assess and grade the symptoms, ultrasound and angiographic aspects.

Results: Regarding the uterus, its volume evolution registered a descending trend, the mean decrease at 30 days being of 25% (-81,6 cm³) and at 90 days of 52%(-173,15 cm³). The fibroids also decreased statistically, the mean global variation at 30 days registering a decrease of -17,66 cm³(27%) and 61% at day 90. The mean global reduction at 30 days was of 44% (-33,18 cm³) and of 62% (-60,85 cm³) at 90 days. Absence of uterine anastomoses lead to proper fibroid decrease whereas their presence diminished the chances.

Conclusions: The uterine and fibroid volumes registered a statistical volume decrease at 30 and 90 days in comparison with the volumes before embolization. Absence of uterine anastomoses led to proper fibroid decrease. Longer evaluation time is needed for an accurate evaluation of volume reduction degree.

Show MeSH
Related in: MedlinePlus