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Computed tomography angiogram for failed uterine artery embolization.

Bruce McLucas1, Babak Yaghmai, Mark Beller

  • 1Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA. mclucas@ucla.edu

Minimally Invasive Therapy & Allied Technologies : MITAT : Official Journal of the Society for Minimally Invasive Therapy
|March 5, 2009
PubMed
Summary
This summary is machine-generated.

Computed tomography angiography (CTA) effectively identifies persistent uterine artery supply after failed embolization. This imaging technique aids in planning repeat treatments and discussing risks with patients.

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Area of Science:

  • Radiology
  • Interventional Radiology
  • Vascular Imaging

Background:

  • Uterine artery embolization (UAE) is a common treatment for symptomatic uterine fibroids.
  • Recurrence of symptoms or fibroid growth can occur after UAE, necessitating further evaluation.
  • Identifying persistent or collateral blood supply is crucial for successful repeat interventions.

Purpose of the Study:

  • To evaluate the efficacy of computed tomography angiography (CTA) in assessing persistent uterine artery supply following failed UAE.
  • To determine the role of CTA in guiding repeat UAE procedures.
  • To assess the accuracy of CTA findings compared to live angiography during repeat UAE.

Main Methods:

  • Retrospective review of patients who underwent UAE for uterine fibroids.
  • Patients with persistent fibroid uptake on follow-up MRI were offered CTA.
  • Comparison of CTA findings with intra-procedural angiography during repeat UAE.

Main Results:

  • Out of 675 UAE procedures, 29 patients showed persistent fibroid uptake on MRI.
  • Twelve patients underwent CTA, and six proceeded to repeat UAE.
  • CTA demonstrated a 75% concurrence with live angiography, identifying various non-uterine blood supplies and confirming findings in most cases.

Conclusions:

  • Computed tomography angiography is a valuable tool for identifying collateral and persistent uterine artery supply to fibroids.
  • CTA facilitates pre-operative planning for repeat UAE and improves patient counseling.
  • This imaging modality offers potential for accurate evaluation of extra-gonadal supply to the uterus.