de Bruijn Annefleur M, Adriaansens Sven-Ole J H, Smink Marieke, Venmans Alexander, Hehenkamp Wouter J K, Smeets Albert J, Lopez Anthony, Huirne Judith A F, Lohle Paul N M
Department of Gynecology, VU Medical Center, De Boelelaan 1117, 1007 MB, Amsterdam, The Netherlands.
Department of Radiology, Elisabeth Tweesteden ziekenhuis, Tilburg, The Netherlands.
Cardiovasc Intervent Radiol. 2019 Mar;42(3):371-380. doi: 10.1007/s00270-018-2081-2. Epub 2018 Oct 4.
To perform an evaluation on safety and efficacy of uterine artery embolization (UAE) in the patients with symptomatic cervical leiomyomata.
Patients with symptomatic cervical leiomyomata who underwent UAE in one specialized hospital were retrospectively analyzed, both clinically and with MR imaging. The 3-month outcomes were assessed with MR imaging and a validated questionnaire. Long-term follow-up was assessed by direct contact or file review. To determine the efficacy of UAE for cervical leiomyomata, the primary objective was to assess the clinical outcome with the UFS-QOL questionnaire, containing the health-related quality of life (HRQOL) and symptom severity score (SSS). To assess safety, the secondary objective included leiomyomata volume reduction, the infarction/complication rate and secondary interventions were needed.
Between 2006 and 2017, eight of 1180 patients underwent UAE and were eligible for inclusion. All embolizations were technically successful (n = 8). At 3 months, all patients showed cervical leiomyomata volume reduction with a median reduction of 41.5% (38.8 cm) compared to baseline (p = 0.012). No complications occurred. At a median follow-up of 3 months (range 1-7, n = 7), the HRQOL and SSS improved with a median difference of 13 points (range - 5 to 60, p = 0.063) and - 13 points (range - 79 to 3, p = 0.046), respectively. Long-term follow-up showed two secondary interventions (median of 43.5 months). Six patients reported no symptom recurrence.
UAE in women with symptomatic cervical leiomyomata is effective and safe with significant improvement in symptoms and quality of life. UAE is a valuable option for women seeking a non-surgical solution.
评估子宫动脉栓塞术（UAE）治疗有症状子宫颈平滑肌瘤患者的安全性和有效性。
回顾性分析在一家专科医院接受UAE治疗的有症状子宫颈平滑肌瘤患者的临床及磁共振成像（MR）资料。通过MR成像和一份经过验证的问卷评估3个月的结局。通过直接联系或查阅档案进行长期随访。为确定UAE治疗子宫颈平滑肌瘤的疗效，主要目标是使用包含健康相关生活质量（HRQOL）和症状严重程度评分（SSS）的UFS-QOL问卷评估临床结局。为评估安全性，次要目标包括平滑肌瘤体积缩小、梗死/并发症发生率以及是否需要二次干预。
2006年至2017年期间，1180例患者中有8例接受了UAE治疗并符合纳入标准。所有栓塞术在技术上均成功（n = 8）。3个月时，所有患者的子宫颈平滑肌瘤体积均缩小，与基线相比，中位缩小率为41.5%（38.8 cm）（p = 0.012）。未发生并发症。中位随访3个月（范围1 - 7个月，n = 7）时，HRQOL和SSS分别改善，中位差异为13分（范围 - 5至60分，p = 0.063）和 - 13分（范围 - 79至3分，p = 0.046）。长期随访显示有两次二次干预（中位时间43.5个月）。6例患者报告无症状复发。
UAE治疗有症状子宫颈平滑肌瘤的女性有效且安全，症状和生活质量有显著改善。UAE是寻求非手术解决方案的女性的一个有价值的选择。
