Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul 03722, Korea.
Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul 03722, Korea.
J Vasc Interv Radiol. 2018 Apr;29(4):497-501. doi: 10.1016/j.jvir.2017.11.022. Epub 2018 Feb 22.
To evaluate safety and efficacy of uterine artery embolization (UAE) for pedunculated subserosal (PS) leiomyomas.
Of 1,069 patients who underwent UAE for symptomatic leiomyomas or adenomyosis from 2007 to 2016, 55 patients (mean age 40.3 y ± 4.8) with 66 PS leiomyomas (mean diameter 6.61 cm ± 2.04) were enrolled. Each PS leiomyoma was categorized into 1 of 2 groups: high-risk PS leiomyoma (stalk diameter < 25% of diameter of leiomyoma) and low-risk PS leiomyoma (stalk diameter 25%-50% of diameter of leiomyoma). MR imaging was performed 3 months after UAE. Rates of infarction and volume reduction were compared between PS leiomyomas and non-PS dominant leiomyomas and between high-risk and low-risk PS leiomyomas. Complications related to PS leiomyomas were assessed.
At a median follow-up of 96 days (range, 36-348 d) after UAE, none of the patients (0%) had complications related to PS leiomyomas, even among high-risk cases. Mean volume reductions of 38.2% and 38.4% were achieved for PS leiomyomas and non-PS dominant leiomyomas, respectively (P = .953). There were 3 (5.5%) minor adverse events, but none were related to PS leiomyoma. There was no significant difference in volume reduction and infarction rates between low-risk and high-risk PS leiomyomas.
UAE is safe and effective in patients with PS leiomyomas even for high-risk cases (stalk diameter < 25% of diameter of leiomyoma). PS leiomyoma should not be considered a contraindication for UAE.
评估子宫动脉栓塞术（UAE）治疗有蒂浆膜下（PS）子宫肌瘤的安全性和有效性。
在 2007 年至 2016 年间，对因症状性子宫肌瘤或子宫腺肌病而行 UAE 的 1069 名患者中，纳入 55 名（平均年龄 40.3 ± 4.8 岁）有 66 个 PS 子宫肌瘤（平均直径 6.61 ± 2.04cm）的患者。每个 PS 子宫肌瘤分为 2 组之一：高危 PS 子宫肌瘤（蒂直径<肌瘤直径的 25%）和低危 PS 子宫肌瘤（蒂直径为肌瘤直径的 25%-50%）。UAE 后 3 个月进行磁共振成像（MRI）检查。比较 PS 子宫肌瘤与非 PS 主导型子宫肌瘤、高危 PS 子宫肌瘤与低危 PS 子宫肌瘤的梗死率和体积缩小率。评估与 PS 子宫肌瘤相关的并发症。
UAE 后中位数随访时间为 96 天（范围 36-348 天），无患者（0%）出现与 PS 子宫肌瘤相关的并发症，即使是高危病例。PS 子宫肌瘤的平均体积缩小率为 38.2%，非 PS 主导型子宫肌瘤为 38.4%（P=0.953）。有 3 例（5.5%）轻微不良事件，但均与 PS 子宫肌瘤无关。低危和高危 PS 子宫肌瘤的体积缩小率和梗死率无显著差异。
即使是高危病例（蒂直径<肌瘤直径的 25%），UAE 治疗 PS 子宫肌瘤也是安全有效的。PS 子宫肌瘤不应被视为 UAE 的禁忌证。
Zotero 插件