Inferior Mesenteric Artery Collaterals to the Uterus during Uterine Artery Embolization: Prevalence, Risk Factors, and Clinical Outcomes

Chang, Suyon; Lee, Mu Sook; Kim, Man Deuk; Yoon, Chang Jin; Jung, Dae Chul; Lee, Myung Su; Park, Sung Il; Won, Jong Yun; Lee, Do Yun

doi:10.1016/j.jvir.2013.05.049

Cited by 23 publications

(16 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the study group examined on the new imaging system, however, DSA had a lower impact on overall exposure than DF. Thus, aortography can be performed to identify collateral supply from different visceral arteries [ 18 ] with this new system without a significant increase in radiation exposure.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of a New X-Ray Imaging System for Interventional Procedures: Improved Image Quality and Reduced Radiation Dose

Schernthaner

Haroun

Nguyen

et al. 2017

Cardiovasc Intervent Radiol

View full text Add to dashboard Cite

PurposeTo compare image quality and radiation exposure between a new angiographic imaging system and the preceding generation system during uterine artery embolization (UAE).Materials and MethodsIn this retrospective, IRB-approved two-arm study, 54 patients with symptomatic uterine fibroids were treated with UAE on two different angiographic imaging systems. The new system includes optimized acquisition parameters and real-time image processing algorithms. Air kerma (AK), dose area product (DAP) and acquisition time for digital fluoroscopy (DF) and digital subtraction angiography (DSA) were recorded. Body mass index was noted as well. DF image quality was assessed objectively by image noise measurements. DSA image quality was rated by two blinded, independent readers on a four-rank scale. Statistical differences were assessed with unpaired t tests and Wilcoxon rank-sum tests.ResultsThere was no significant difference between the patients treated on the new (n = 36) and the old system (n = 18) regarding age (p = 0.10), BMI (p = 0.18), DF time (p = 0.35) and DSA time (p = 0.17). The new system significantly reduced the cumulative AK and DAP by 64 and 72%, respectively (median 0.58 Gy and 145.9 Gy*cm2 vs. 1.62 Gy and 526.8 Gy*cm2, p < 0.01 for both). Specifically, DAP for DF and DSA decreased by 59% (75.3 vs. 181.9 Gy*cm2, p < 0.01) and 78% (67.6 vs. 312.2 Gy*cm2, p < 0.01), respectively. The new system achieved a significant decrease in DF image noise (p < 0.01) and a significantly better DSA image quality (p < 0.01).ConclusionsThe new angiographic imaging system significantly improved image quality and reduced radiation exposure during UAE procedures.Electronic supplementary materialThe online version of this article (doi:10.1007/s00270-017-1821-z) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionmentioning

confidence: 99%

Characteristics of a New X-Ray Imaging System for Interventional Procedures: Improved Image Quality and Reduced Radiation Dose

Schernthaner

Haroun

Nguyen

et al. 2017

Cardiovasc Intervent Radiol

View full text Add to dashboard Cite

show abstract

“…The ovarian arteries usually arise from the abdominal aorta below the renal artery ( Fig. 2) [36,44]. The round ligament artery originates from the inferior epigastric artery or femoral artery so that it can be visible when a flush abdominal aortogram is performed [42,43].…”

Section: Uterine Arterial Networkmentioning

confidence: 99%

“…3). Collaterals to the uterus from ovarian artery, inferior mesenteric artery, round ligament artery, and internal pudendal artery are observed on angiography in 3.8, 1.3, 0.2, and 0.2 % of patients, respectively [44]. Depiction of these arteries is of importance because in some women, they may actively participate to the uterine arterial supply and may be a cause of failed TAE [44].…”

Section: Uterine Arterial Networkmentioning

confidence: 99%

Transcatheter Arterial Embolization for Postpartum Hemorrhage: Indications, Technique, Results, and Complications

Soyer

Dohan

Dautry

et al. 2015

Cardiovasc Intervent Radiol

View full text Add to dashboard Cite

Postpartum hemorrhage (PPH) is a potentially life-threatening condition, which needs multidisciplinary management. Uterine atony represents up to 80 % of all causes of PPH. Transcatheter arterial embolization (TAE) has now a well-established role in the management of severe PPH. TAE allows stopping the bleeding in 90 % of women with severe PHH, obviating surgery. Pledgets of gelatin sponge as torpedoes are commonly used for safe TAE, and coils, glue, and microspheres have been primarily used in specific situations such as arterial rupture, pseudoaneurysm, and arteriovenous fistula. TAE is a minimally invasive procedure with a low rate of complications, which preserves future fertility. Knowledge of causes of PPH, potential risks, and limitations of TAE is essential for a timely decision, optimizing TAE, preventing irreversible complications, avoiding hysterectomy, and ultimately preserving fertility.

show abstract

“…Addition aberrant arterial supply to the fibroid may arise from the inferior mesenteric artery, the round ligament artery, and the internal pudendal artery. 44,45 In patients with an absent or diminutive UA, or in cases of prior pelvic surgery or fundal fibroids, close attention to other sources of arterial supply must be given to enhance the clinical success of UAE.…”

Section: Aberrant Vascular Supplymentioning

confidence: 99%

Updates on Uterine Artery Embolization

Kohi

Spies

2018

Semin intervent Radiol

View full text Add to dashboard Cite

Uterine fibroids (leiomyomas) are the most common benign neoplasm of the female pelvis and have a lifetime prevalence exceeding 80% among African American women and approaching 70% among Caucasian women. Approximately 50% of women with fibroids experience symptoms which may include menorrhagia that may result in anemia, bulk symptoms with bladder and bowel dysfunction and abdominal protrusion, dysmenorrhea, and infertility. Hysterectomy remains the most common treatment option for fibroids and concerns have been raised about the overuse of this procedure. Uterine artery embolization (UAE) is now a well-established uterine preserving and minimally invasive therapy for symptomatic fibroids. Since its introduction, strong evidence for safety and efficacy of UAE has been generated with low rates of complications. This review will discuss UAE for the management of symptomatic uterine fibroids with special focus on emerging technical approaches and novel periprocedural patient care.

show abstract

Inferior Mesenteric Artery Collaterals to the Uterus during Uterine Artery Embolization: Prevalence, Risk Factors, and Clinical Outcomes

Cited by 23 publications

References 29 publications

Characteristics of a New X-Ray Imaging System for Interventional Procedures: Improved Image Quality and Reduced Radiation Dose

Characteristics of a New X-Ray Imaging System for Interventional Procedures: Improved Image Quality and Reduced Radiation Dose

Transcatheter Arterial Embolization for Postpartum Hemorrhage: Indications, Technique, Results, and Complications

Updates on Uterine Artery Embolization

Contact Info

Product

Resources

About