Aims and objectives
Uterine fibroids,
also called myoma or leiomyoma,
are the most common benign tumors of the female reproductive tract (1) and present in more than 40 % of women 40 years of age (2).
They arise from the uterine smooth muscular tissue of myometrium and consist of extracellular matrix; their etiopathology is multifactorial (3).
Approximately 50 % of patients are asymptomatic,
but often fibroids can cause significant morbidity (4).
Symptoms include abnormal uterine bleeding,
heavy mestrual bleeding,
and symptoms connected to the impact of uterus on...
Methods and materials
Between January and September 2017 thirty consecutive patients (age range 28-47,average 32 years)
undergoing UAE were enrolled for transferal (group a) and transaradial approach (group b).
The indication for treatment was based onclinical conditions,
gynecological examination with ultrasound and pelvic magnetic resonance examination.
A microcatheter was advanced,
into the horizontal portion of the uterine artery.
Arterial embolization was performed using embosphere particles.
No other embolic agents (embolic coils) were added in any cases.
The angiographic endpoint of embolization was defined as stasis of the flow...
Results
The average of VAS in group b was lower than in group a in each evaluation on the basis of Mann-Whitney U-test (6
hours=P<0.20,
12 hours= P<0.07,
18 hours=P<0.02,
24 hours=P<0.22).
Also the QoL score at 24 hours had better results in the transradial
group.
(group A= average 18.0 (17.0-21.4); group b: average 14.0 (13.0-16.0).
Conclusion
Transradial approach improves the QOL and VAS of patients undergone to UAE in comparison to standard transfemoralapproach.
Our results demonstratesd that post-procedural pain <24 hours was significally less in UAE with transradial approach.
Transradial access is more over associated with advantages such as improved patients comfort,
fewer access site cimplications,
earlier ambulation,
and reduced costs (17-18-19-20).
Thanks to transradial approach patients are not restricted in flexing the hip,
they can assume the most comfortable position (and this can assist in pain control after UAE).
Patients...
References
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Myometrial cells undergo fibrotic transformation under the influence of transforming growth factor beta-3.
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Silberzweig JE et al.
Management of uterine fibroids: a focus on uterine-sparing interventional techniques.
Radiology.
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Ciavattini A,
Di Giuseppe J,
Stortoni P,
Montik N,
Giannubilo SR,
Litta P et al.
Uterine fibroids: pathogenesis and interactions with endometrium and endomyometrial junction.
Obstetric and Gynecology Internetional Volume 2013.
Olejer A,
Olszak-Wasik K,
Czerwinska-Bednarska A.
Long-term intermittent pharmacological therapy of uterine fibroids...