UTERINE ARTERY EMBOLIZATION FOR UTERINE LEIOMY01VIATA USING POLYVINYL ALCOHOL PARTICLES, TRIAL TO IMPROVE TECHNICAL SUCCESS OF THE PROCEDURE
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Purpose: To evaluate the technical results, efficacy and safety of uterine artery embolization(UAE) with the use of polyvinyl alcohol particles (PVAP) in the management of symptomatic uterine leiomyomata. ' Materials and Methods: Between November 2002 and July 2005, Twenty women (mean age 36 years) with symptomatic uterine leiomyomata underwent bilateral UAE with use of PVAP. Vascular access with percutaneous femoral artery approach was followed by transcatheter delivery of PVAP into uterine arteries under fluoroscopic guidance. Embolization was offered as an alternative to surgery in all women who had been treated unsuccessfully with medical therapy. Reruns: 95% of procedures were technically successful. Devascularization of the leiomyomaia was achieved. Variant anatomy was the reason of technical failure in one woman (5%). After a mean followup duration of 18 months (range 6-30 months), eighteen women (90%) reported improvement in their - symptoms and one women was subjected finally to hysterectomy. Fifteen women (75%) reported coinplete resolution of menorrhagia at the initial follow-up. One woman (5%) with multiple leiomyomata required a second embolization procedure because of persisting symptoms at 6 months. She is currently symptom free - after 24 months. Two women with submucosal leiomyomata experienced necrotic tumor expulsion 4 and. . 7 months after the procedure which need hysteroscopic assistance. All women resumed their menstruation after the procedure. Conclusion: Our early experience with UAE with the use of PVAP indicates that it is safe and efficacious in controlling menorrhagia and pressure symptoms.