Helmberger T K, Jakobs T F, Reiser M F
Institut für Klinische Radiologie, Klinikum der Universität München-Grosshadern, Munich.
Radiologe. 2003 Aug;43(8):634-40. doi: 10.1007/s00117-003-0933-4.
Uterine leiomyomas are the most common benign tumors of the female urogenital tract. Beside the classic surgical treatment options the minimal-invasive embolization therapy of the leiomyomas increasingly gains importance world-wide. Technique, complications, and results of uterine leiomyoma embolization will be presented.
After careful evaluation of indications for embolization the procedure is mostly performed under conscious sedation. A single-sided femoral access route together with cross-over technique generally allows for a flow-directed embolization via both uterine arteries. After embolizing the vessels supplying the tumor, the uterine arteries should be still patent.
The success rate of embolization of uterine leiomyomas ranges between 85 and 100%, whereas a reduction in size of the tumors in 42 to 83% and a relief of symptoms in up to 96% can be achieved. The total complication rate is about 10% with mainly "minor complications". Worldwide only three deaths following embolization of uterine leiomyomas were reported.
The high technical and clinical success rate together with a low complication rate make the embolization of uterine leiomyomas a minimally-invasive alternative to the classic treatment. As long term results are not available indication to embolization of uterine leiomyomas must be carefully established in consensus with gynecologists.
子宫平滑肌瘤是女性泌尿生殖道最常见的良性肿瘤。除了传统的手术治疗选择外，子宫平滑肌瘤的微创栓塞治疗在全球范围内越来越受到重视。本文将介绍子宫平滑肌瘤栓塞术的技术、并发症及结果。
在仔细评估栓塞适应症后，该手术大多在清醒镇静下进行。单侧股动脉入路联合交叉技术通常可实现经双侧子宫动脉的血流导向栓塞。栓塞肿瘤供血血管后，子宫动脉应仍保持通畅。
子宫平滑肌瘤栓塞术的成功率在85%至100%之间，肿瘤体积缩小率在42%至83%之间，症状缓解率高达96%。总并发症发生率约为10%，主要为“轻微并发症”。全球范围内仅报道了3例子宫平滑肌瘤栓塞术后死亡病例。
子宫平滑肌瘤栓塞术的高技术成功率和临床成功率以及低并发症发生率使其成为传统治疗的微创替代方法。由于尚无长期结果，子宫平滑肌瘤栓塞术的适应症必须与妇科医生协商一致后谨慎确定。
