Kapranov S A, Bobrov B Iu
Angiol Sosud Khir. 2006;12(2):51-6.
The article deals with analysis of technical and anatomical factors influencing the efficacy of uterine arteries embolization (UAE) in treatment of patients with uterine myoma. Based on experience gained in 420 interventions, the authors revealed that inefficiency of UAE may be attributed to the following causes: 1) a technical failure associated with anatomical peculiarities of the uterine artery or a spasm thereof; 2) incomplete embolization apparently attributable to both technical and anatomical factors; 3) an adventitious restoration of blood supply to the uterine myoma. We also determined the significance of utero-ovarian arterial anastomoses in blood supply of the myomatous nodes, suggesting technical manipulations making it possible to attain adequate embolization thereof, if such. Technical and anatomical factors play a decisive role in successful outcomes of UAE, which, if failed due to restoration or preservation of blood supply of the myomatous nodes, should be followed by a repeat intervention.
本文探讨了影响子宫肌瘤患者子宫动脉栓塞术(UAE)疗效的技术和解剖学因素。基于420例手术的经验,作者发现UAE无效可能归因于以下原因:1)与子宫动脉解剖特点或痉挛相关的技术失败;2)显然归因于技术和解剖学因素的不完全栓塞;3)子宫肌瘤血供的意外恢复。我们还确定了子宫-卵巢动脉吻合在肌瘤结节血供中的意义,提出了如果可能实现对其充分栓塞的技术操作。技术和解剖学因素在UAE的成功结果中起决定性作用,如果由于肌瘤结节血供的恢复或保留而失败,应进行重复干预。