Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Jaczewskiego 8 Str., 20-090 Lublin, Poland.
Department of Endocrinology, Medical University of Lublin, 20-090 Lublin, Poland.
Medicina (Kaunas). 2022 Nov 27;58(12):1732. doi: 10.3390/medicina58121732.
Uterine artery embolization (UAE) has become an accepted and widely performed therapy for patients with symptomatic (reporting at least two of the following symptoms: severe or prolonged menstrual bleeding, abdominal pain, tension in abdomen, problems with urination, constipation or anemia) uterine fibroids. Although in the majority of cases, bilateral occlusion is required to obtain a successful clinical outcome, there are patients in whom treatment of only one uterine artery could be attempted. There are several reasons for unilateral UAE: hemodynamic conditions, technical difficulties, anatomical variants and unilateral dominancy of blood supply to the fibroid. Our aim is to present our 10-year experience with unilateral UAE and evaluate the radiological and clinical outcomes. Records of 369 patients with fibroids who underwent UAE from 2010 to 2021 were analyzed. We identified 26 patients treated with unilateral uterine artery embolization and analyzed the data of these patients. All patients attended medical consultation, were assessed using a five-grade symptom scale and underwent MRI examination. Clinical response was evaluated at least 6 months after the procedure and was categorized to one of the following groups: complete improvement, partial improvement, no change and a worsening in symptoms. Twenty-two patients (85%) reported at least partial improvement 6 months following the procedure. One patient required secondary embolization due to recanalization. The secondary procedure was successful, and complete improvement was achieved. One patient did not observe any clinical improvement, and in two cases, symptom recurrence was observed. All three patients were referred for surgical treatment. No major complications were noted. Overall, the success rate was 88%. The results of our study support the statement that elective unilateral embolization is an appropriate treatment in patients with a dominant uterine artery.
子宫动脉栓塞术（UAE）已成为治疗有症状（报告至少以下两种症状：严重或长时间的月经出血、腹痛、腹部紧张、排尿问题、便秘或贫血）子宫肌瘤患者的一种公认且广泛应用的治疗方法。尽管在大多数情况下，需要双侧闭塞才能获得成功的临床效果，但也有一些患者可以尝试单侧子宫动脉栓塞治疗。单侧 UAE 的原因有几种：血流动力学条件、技术困难、解剖变异和子宫肌瘤的单侧供血优势。我们的目的是展示我们 10 年的单侧 UAE 经验，并评估其放射学和临床结果。
分析了 2010 年至 2021 年期间接受 UAE 治疗的 369 例子宫肌瘤患者的记录。我们确定了 26 例接受单侧子宫动脉栓塞治疗的患者，并分析了这些患者的数据。所有患者均接受了医疗咨询，采用五级症状量表进行评估，并进行了 MRI 检查。临床反应在手术后至少 6 个月进行评估，并分为以下几个组别之一：完全改善、部分改善、无变化和症状恶化。
手术后 6 个月，22 例患者（85%）报告至少部分改善。1 例患者因再通需要二次栓塞。二次手术成功，完全改善。1 例患者未观察到任何临床改善，2 例患者症状复发。所有这 3 例患者均转至外科治疗。未观察到重大并发症。总体而言，成功率为 88%。
在优势子宫动脉患者中，选择性单侧栓塞是一种合适的治疗方法。
