Córdoba-Esquivel JA, Guerrero-Avendaño GML; Enríquez-García R

Language: Spanish
References: 11
Page: 3-9
PDF size: 474.22 Kb.

ABSTRACT

Introduction: Uterine myomas are the most common form of pelvic tumor in women of reproductive age; however, an estimated 70% of women develop myomas at some point in their life. Twenty-five percent of patients present symptoms related to them. The traditional treatment has been hysterectomy, but today there are minimally invasive techniques which have been shown to provide a safe therapeutic alternative.
Objective: Assess the percentage reduction of myomas with the different types of embolizing materials used in embolization of uterine arteries, to see which has the greatest impact on reducing their size.
Methods: A retrospective, observational study was conducted of series of cases taken from Hospital General de Mexico and Hospital Star Medica Centro, including 33 patients with myomatosis of large and medium size elements, who underwent embolization of uterine arteries, in an age range of 27 to 49 years. Subjects underwent a magnetic resonance study before and after the operation, with follow-up for year. They were divided in groups depending on the type of embolizing material used.
Results: On average, patients embolized with particles of polyvinyl alcohol had a 43.5% reduction of their myoma. Patients in whom microspheres were used had a 53.9% reduction. Patients in whom Gelfoam^® was used had a 57.5% reduction.
Conclusions: Embolization of uterine arteries is an alternative for management of uterine myomatosis. There are different types of embolizing materials, but not all have the same desired effect on reduction in volume of myomas. Although they all show a significant reduction, in this study Gelfoam^® showed the greatest influence, but the sample of patients in whom it was used was very small.

REFERENCES

1. Sociedad Española de Ginecología y Obstetricia. Miomas uterinos. Barcelona: Elsevier España; 2014. 57(7):312-24.

2. Ravina JH, Herbreteau D, Ciraru-Vigneron N, et al. Arterial embolization to treat uterine myomata. Lancet. 1995;346:671-2.

3. Goodwin SC, McLucas B, Lee M. Uterine artery embolization for the treatment of uterine leiomyomata midterm results. J Vasc Interv Radiol. 1999;10:1159-65.

4. Guerrero AGML, Enríquez GR, Viramontes TG. Embolización de arterias uterinas. Alternativa para el tratamiento de la miomatosis uterina. Experiencia en 43 pacientes. Ande Rad Mex. 2007;4:277-83.

5. Toda A, Sawada K, Osuga K, Maeda N, Higashihara H, Sasano T, et al. Efficacies of uterine artery embolization for symptomatic uterine fibroids using gelatin sponge: a single center experience and literature review. Int J Womens Health. 2016;8:397-404.

6. Senkichi J. Agentes de embolización. Rev Int. 2016;(1):16-26.

7. Wang X, Zhang Z, Pan J, Zhang W. Effects of embolic agents with diferent particle sizes on interventional treatment of uterine fibroids. Pak Med Sci. 2015;3:1490-5.

8. Lacayo EA, Richman DL, Acord MR, Wolfman DJ, Caridi TM, Desale SY, et al. Leiomyoma infarction after uterine artery embolization: influence of embolic agent and leiomyoma size and location on outcome. J Vasc Radiol 2017;3:1-8.

9. Abramowitz SD. Comparison of four embolic materials at uterine artery embolization by using postprocedural MR imaging enhancement. Rad. 2009;250:482-7.

10. Beinfeld MT, Bosch JL, Isaacson KB. Cost-effectiveness of uterine artery embolization and histerectomy for uterine fibroids. Rad. 2004;230:207-13.

11. Lucio S, Liliana M, Castellari M. Embolización arterial de miomas uterinos: resultados morfológicos y funcionales a corto y mediano plazo. Rad Int Serv Gin Inst Oulton. 2010;74:158-70.