Interventional Radiology, Department of Bioimaging, Policlinico Agostino Gemelli, Catholic University of Sacred Heart, Rome, Italy.
Gynecology, Department of Women Health, Policlinico Agostino Gemelli, Catholic University of Sacred Heart, Rome, Italy.
Radiol Med. 2018 May;123(5):385-397. doi: 10.1007/s11547-017-0843-6. Epub 2018 Jan 22.
To evaluate effectiveness and safety of UFE as alternative to surgery, in treatment of uterine fibromatosis.
METHODS/MATERIALS: 255 patients (aged 26-55) with symptomatic UF, indication for surgery, followed in our center (2000-2014), single or multiple fibroids, pain and/or functional/compressive disorders, underwent embolization: injection of PVA particles (150-900 μm) from distal portion of uterine arteries (ascending section). Primary end-point: flow-stop distally to injection site, disappearance of lesion design, preservation of flow in main trunk of UA. Secondary end-point: control of pain and functional/compressive disorders during follow-up (2-7 years).
Procedure was performed bilaterally in 250 patients (98%). Mean duration: 47 min (average fluoroscopy: 10:50 min). Post-embolization pelvic pain (according with VAS score) was on average 2.2 at discharge (24 h). Follow-up at 2 years: resolution of menstrual disorders in 78% of patients and improvement in 14%; pain disappeared in 66%; significant improvement of menstrual flow and HCT/HB levels, decrease in total uterine (57.7%)/dominant fibroid (76.1%) volume. Recurrence in 18 patients.
UFE represents an excellent alternative to surgical treatment: it is safe, tolerable and effective both in short and long term, with evident advantages in economic and social terms.
评估 UFE 在治疗子宫纤维瘤中的疗效和安全性，替代手术。
方法/材料：2000 年至 2014 年，在我们中心就诊的 255 名（年龄 26-55 岁）有症状的 UF、手术适应证、单发或多发肌瘤、疼痛和/或功能/压迫性疾病的患者，接受了栓塞治疗：从子宫动脉的远端（升支）注射 PVA 颗粒（150-900μm）。主要终点：注射部位远端血流停止，病变消失，UA 主干保留血流。次要终点：随访期间（2-7 年）疼痛和功能/压迫性疾病的控制情况。
250 例患者（98%）行双侧手术。平均手术时间：47 分钟（平均透视时间：10:50 分钟）。栓塞后盆腔疼痛（根据 VAS 评分）平均为 2.2 分（出院时 24 小时）。2 年随访：78%的患者月经紊乱得到缓解，14%的患者得到改善；疼痛消失 66%；月经流量和 HCT/HB 水平明显改善，总子宫（57.7%）/优势肌瘤（76.1%）体积减少。18 例患者复发。
UFE 是手术治疗的极好替代方法：它在短期和长期内均安全、耐受且有效，在经济和社会方面具有明显优势。
