Uterine artery embolization for uterine leiomyoma: the state of the problem

Kalmykov E.L., Rakhimov F.R., Umarzoda S.G., Baratov A.K.

1) Vascular and Endovascular Surgery Clinic, Helios University Hospital, Wuppertal, Germany; 2) Surgical Diseases Department No. 2, Avicenna Tajik State Medical University, Dushanbe, Tajikistan; 3) Department of Oncology and Radiation Diagnosis, Avicenna Tajik State Medical University, Dushanbe, Tajikistan; 4) Department of Endovascular Surgery, Republican Scientific Center for Cardiovascular Surgery, Dushanbe, Tajikistan
The presented review of the literature is devoted to the diagnosis and treatment of uterine leiomyoma (UL). It considers the impact of UL on reproductive function and the place of uterine artery embolization (UAE) in its treatment. The review describes the technical features of UAE, different vascular approaches to its implementation, and the use of various embolization agents. Analysis of a number of randomized trials could provide information on the comparative efficiency of UAE, on the one hand, and hysterectomy and myomectomy, on the other, in treating UL. Particular emphasis is laid to the description of postembolization syndrome, the prevention and treatment of which are still an insufficiently developed aspect. Various specific and nonspecific UAE complications that can occur both during the procedure and in the immediate and late postprocedural periods are analyzed. Attention is focused on an important point, such as the impact of UAE on subsequent pregnancies and childbirth. Whether transient amenorrhea and ovarian dysfunction may develop after UAE is considered. In addition, information is given on morphological studies of the uterus after UAE.
Conclusion. Thus, the analysis of the literature has shown that, despite contradictory data at times, UAE can be considered as an alternative for the surgical treatment of UL, showing rather good results in the early and late postoperative periods.

Keywords

uterine leiomyoma
uterine artery embolization
postembolization syndrome
hysterectomy
myomectomy

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Received 19.03.2020

Accepted 17.06.2020

About the Authors

Egan L. Kalmykov, MD, PhD, Vascular Surgeon, Vascular and Endovascular Surgery Clinic, Helios University Hospital, Wuppertal. E-mail: egan0428@mail.ru.
ORCID: 0000-0001-6784-2243, Researcher ID: K-9827-2013, SCOPUS ID: 36172240400, Author ID: 843609, SPIN-code: 8623-8897.
Farshed R. Rakhimov, MD, Postgraduate Student, Department of Surgical Diseases No. 2, Avicenna Tajik State Medical University, Dushanbe.
E-mail: frrahimov@mail.ru. ORCID: 0000-0001-7418-1383.
Saida G. Umarzoda, MD, PhD, Associate Professor, Department of Oncology and Radiation Diagnostics, Avicenna Tajik State Medical University, Dushanbe.
E-mail: saida.umarova@bk.ru. ORCID:0000-0002-3739-4854, Researcher ID: AAE-7337-2020.
Alisher K. Baratov, MD, PhD, Associate Professor, Endovascular Surgeon, Department of Endovascular Surgery, Republican Scientific Center for Cardiovascular Surgery, Dushanbe. E-mail: alishbar@rambler.ru. ORCID: 0000-0002-8072-5751, Researcher ID: AAE-6818-2019, Scopus ID: 8249648700, Author ID: 268956, SPIN-code: 6576-1680.

For citation: Kalmykov E.L., Rakhimov F.R., Umarzoda S.G., Baratov A.K. Uterine artery embolization for uterine leiomyoma: the state of the problem.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2020; 9: 18-26 (in Russian).
https://dx.doi.org/10.18565/aig.2020.9.18-26

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