Aims and objectives
Uterine artery embolization (UAE) is widely used for symptomatic uterine fibroids treatment [1,2].
Final result of UAE is complete or partial occlusion of uterine arteries.
Anyway there is no single technical protocol for UAE.
Different types of surgical approaches are used: transfemoral unilateral,
transfemoral bilateral,
transradial [3].
Also there is large variety of instruments and embolic materials for UAE.
At last there is no one standard protocol of acquisition and fluoroscopy for UAE.
In many cases this leads to exceeding of radiation dose,
that could...
Methods and materials
This is a prospective study.
Main inclusion criteria were: symptomatic fibroids,
absence of any gynecologic surgery (including UAE) in anamnesis.
86 patients with uterine fibroids were included and randomized into two groups.
Group1 included 43 patients,
who underwent UAE with low-dose radiation protocol.
Group 2 included 42 patients (1 of 43 excluded during the study for co-morbidity) with standard radiation protocol.
Mean body mass index (BMI) in group 1 was 26,3,
and in group 2 mean BMI was 23,9.
Mean age in group 1 was...
Results
Mean dose in group 1 was 676,5+103,7 mGym2 ranging from 421,1 to 840,6 mGym2.
In group 2 mean dose reached 2938,7+719,4 mGym2 with range 1853,6-4875,7 mGym2.
The difference between two groups was considered to be statistically significant (P<0,0001).
Complete fibroid necrosis was achieved in 41 case of 43 (95,3%) in group 1,
and in 41 case of 42 (97,6%) in group 2.
There was no statistically significant difference between two groups (p=0,576).
There were no major complications in both groups,
including possible effects of non-target...
Conclusion
Low-dose protocol with native non-subtraction acquisition mode allows to reduce radiation dose in UAE significantly.
It could be recommended for all UAEs.
Personal information
D.
Akinfiev,
MD
National Medical Research Center for Obstetrics,
Gynecology and Perinatology n.a.
V.I.
Kulakov,Department of Radiology,
Moscow,
Russian Federation.
117997
Academician Oparin st,
4
Moscow,
Russian Federation
Phone: + 7-926-3990069
e-mail:
[email protected]
References
Donnez J,
Donnez O,
Dolmans MM.
The current place of medical therapy in uterine fibroid management.
Best Pract Res Clin Obstet Gynaecol.
2017 Oct 22.
pii: S1521-6934(17)30171-2.
Borah BJ,
Yao X,
Laughlin-Tommaso SK,
Heien HC,
Stewart EA.
Effectiveness of Uterine Leiomyoma Procedures Using a Large Insurance Claims Database.
Obstet Gynecol.
2017 Nov;130(5):1047-1056.
Resnick NJ,
Kim E,
Patel RS,
Lookstein RA,
Nowakowski FS,
Fischman AM.
Uterine artery embolization using a transradial approach: initial experience and technique.
J Vasc Interv Radiol.
2014 Mar;25(3):443-7.
-Muenkler et al.
Radiation...