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Endovascular Embolization of the Uterine Arteries in Giant Uterine Fibroids

https://doi.org/10.20862/0042-4676-2021-102-3-172-177

Abstract

Choosing a treatment option for uterine fibroids is today one of the most relevant problems in gynecological practice. Thanks to the success of modern medicine and the increased level of the population’s culture, female patients seek medical help without waiting for the tumor to acquire significant sizes. However, in practice, there are cases when fibroids reach gigantic sizes. Hysterectomy is a traditional approach to treating uterine fibroids of these sizes according to the current clinical guidelines. The introduction of new high-tech treatments, such as uterine artery embolization, has led to a revision of radical surgery, by giving preference to alternative approaches especially in cases where the patient desires to preserve the reproductive organ. The paper describes a clinical case that confirms an individual approach to choosing a treatment option towards organ-sparing surgery for giant uterine fibroids. The use of endovascular embolization of the uterine arteries as a treatment for giant uterine fibroids is shown to be justified as an organ-sparing surgery if the patient desires to preserve reproductive function.

About the Authors

B. M. Sharafutdinov
Kazan State Medical Academy – Branch of Russian Medical Academy of Continuing Professional Education; Medical and Sanitary Unit, Kazan (Volga Region) Federal University
Russian Federation

Bulat М. Sharafutdinov, Cand. Med. Sc., Assiatant Professor, Chair of Cardiology, Endovascular and Cardiovascular Surgery, Kazan State Medical Academy – Branch of Russian Medical Academy of Continuing Professional Education; Head of Department of Endovascular Methods of Diagnosis and Treatment, Medical and Sanitary Unit, Kazan (Volga Region) Federal University

ul. Mushtari, 11, Kazan, 420012,

ul. Chekhova, 1А, Kazan, 420043



E. Yu. Antropova
Kazan State Medical Academy – Branch of Russian Medical Academy of Continuing Professional Education
Russian Federation

Еlena Yu. Antropova, Cand. Med. Sc., Associate Professor, Chair of Obstetrics and Gynecology

ul. Mushtari, 11, Kazan, 420012



S. A. Ryzhkin
Kazan State Medical Academy – Branch of Russian Medical Academy of Continuing Professional Education; Kazan State Medical University; Kazan (Volga Region) Federal University; Federal Center for Toxicological, Radiation and Biological Safety
Russian Federation

Sergey А. Ryzhkin, Dr. Med. Sc., Associate Professor, Chair of Radiology Diagnostics, Kazan State Medical Academy – Branch of Russian Medical Academy of Continuing Professional Education; Associate Professor, Chair of General Hygiene, Kazan State Medical University; Associate Professor, Chair of Medical Physics, Kazan (Volga Region) Federal University; Senior Researcher, Department of Radiobiology, Federal Center for Toxicological, Radiation and Biological Safety

ul. Mushtari, 11, Kazan, 420012,

ul. Butlerova, 49, Kazan, 420012,

ul. Kremlyevskaya, 18, Kazan, 420008,

Science town – 2, Kazan, 420075



A. F. Khalirakhmanov
Medical and Sanitary Unit, Kazan (Volga Region) Federal University; Kazan (Volga Region) Federal University
Russian Federation

Ayrat F. Khalirakhmanov, Cand. Med. Sc., Department of Endovascular Methods of Diagnosis and Treatment, Medical and Sanitary Unit, Kazan (Volga Region) Federal University; Senior Lecturer, Chair of Surgery, Obstetrics and Gynecology, Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Senior Researcher, Department of Radiobiology, Federal Center for Toxicological, Radiation and Biological Safety

ul. Chekhova, 1А, Kazan, 420043, 

ul. Kremlyevskaya, 18, Kazan, 420008



I. V. Klyucharov
Kazan (Volga Region) Federal University
Russian Federation

Igor V. Klyucharov, Cand. Med. Sc., Associate Professor, Chair of Fundamental Principles of Clinical Medicine, Institute of Fundamental Medicine and Biology

ul. Kremlyevskaya, 18, Kazan, 420008



I. R. Galimova
Medical and Sanitary Unit, Kazan (Volga Region) Federal University
Russian Federation

Il’mira R. Galimova, Cand. Med. Sc., Associate Professor, Deputy Chief Physician for Obstetric and Gynecological Care

ul. Chekhova, 1А, Kazan, 420043



M. I. Mazitova
Kazan State Medical Academy – Branch of Russian Medical Academy of Continuing Professional Education
Russian Federation

Мadina I. Mazitova, Dr. Med. Sc., Professor, Chair of Obstetrics and Gynecology

ul. Mushtari, 11, Kazan, 420012,



M. K. Mikhaylov
Kazan State Medical Academy – Branch of Russian Medical Academy of Continuing Professional Education
Russian Federation

Мars K. Mikhaylov, Dr. Med. Sc., Professor, Chief of Chair of Radiology Diagnostics

ul. Mushtari, 11, Kazan, 420012,



References

1. Moss JG, Cooper KG, Khaund A, et al. Randomised comparison of uterine artery embolisation (UAE) with surgical treatment in patients with symptomatic uterine fibroids (REST trial): 5 year results. BJOG. 2011; 118(8): 936–44. https://doi.org/10.1111/j.1471-0528.2011.02952.x.

2. de Bruijn AM, Ankum WM, Reekers JA, et al. Uterine artery embolization vs hysterectomy in the treatment of symptomatic uterine fibroids: 10-year outcomes from the randomized EMMY trial. Obstet Gynecol Survey. 2016; 71(11): 653–5. https://doi.org/10.1097/01.ogx.0000503331.67536.b9.

3. Smeets AJ, Nijenhuis RJ, van Rooij WJ. Uterine artery embolization in patients with a large fibroid burden: long-term clinical and MR follow-up. Cardiovasc Intervent Radiol. 2010; 33(5): 943–8. https://doi.org/10.1007/s00270-009-9793-2.

4. Kim JJ, Kurita T, Bulun SE. Progesterone action in endometrial cancer, endometriosis, uterine fibroids, and breast cancer. Endocr Rev. 2013; 34(1): 130–62. https://doi.org/10.1210/er.2012-1043.

5. Silberzweig JE, Powell DK, Matsumoto AH, Spies JB. Management of uterine fibroids: a focus on uterine-sparing interventional techniques. Radiology. 2016; 280(3): 675–92. https://doi.org/10.1148/radiol.2016141693.

6. Goodwin SC, Spies JB, Worthington-Kirsch R, et al. Uterine artery embolization for treatment of leiomyomata: long-term outcomes from the FIBROID Registry. Obstet Gynecol. 2008; 111(1): 22–33. https://doi.org/10.1097/01.AOG.0000296526.71749.c9.

7. Llewellyn O, Patel NR, Mallon D, et al. Uterine artery embolisation for women with giant versus non-giant uterine fibroids: a systematic review and meta-analysis. Cardiovasc Intervent Radiol. 2020; 43(5): 684–93. https://doi.org/10.1007/s00270-019-02359-7.

8. Vashisht A, Studd J, Carey A, Burn P. Fatal septicaemia after fibroid embolisation. Lancet. 1999; 354(9175): 307–8. https://doi.org/10.1016/S0140-6736(99)02987-6.

9. Pelage JP, Le Dref O, Soyer P, et al. Fibroid-related menorrhagia: treatment with superselective embolization of the uterine arteries and midterm follow-up. Radiology. 2000; 215(2): 428–31. https://doi.org/10.1148/radiology.215.2.r00ma11428.

10. Katsumori T, Nakajima K, Mihara T. Is a large fibroid a high-risk factor for uterine artery embolization? Am J Roentgenol. 2003; 181(5): 1309–14. https://doi.org/10.2214/ajr.181.5.1811309.

11. Çakır V, Ballı Ö. Arterial embolization in large uterine fibroids: a 4-year single center experience. Int J Sci Res Manag. 2019; 7(10): 268–74. https://doi.org/10.18535/ijsrm/v7i10.mp01.

12. Nasser F, Boueri Affonso B, Glauber de Jesus-Silva S, et al. Embolização de mioma uterino em mulheres portadoras de miomas volumosos. Rev Bras Ginecol Obstet. 2010; 32(11): 530–5 (in Spain). https://doi.org/10.1590/S0100-72032010001100003.


Review

For citations:


Sharafutdinov B.M., Antropova E.Yu., Ryzhkin S.A., Khalirakhmanov A.F., Klyucharov I.V., Galimova I.R., Mazitova M.I., Mikhaylov M.K. Endovascular Embolization of the Uterine Arteries in Giant Uterine Fibroids. Journal of radiology and nuclear medicine. 2021;102(3):172-177. (In Russ.) https://doi.org/10.20862/0042-4676-2021-102-3-172-177

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ISSN 0042-4676 (Print)
ISSN 2619-0478 (Online)