Uterine Vascular Anomalies: Management and Treatment Overview

Area of Science:

• Radiology
• Vascular Medicine
• Gynecology

Background:

• Uterine vascular anomalies (UVAs) are rare but can cause life-threatening hemorrhage.
• Current understanding and management strategies for UVAs require standardization for clarity and effective patient care.

Purpose of the Study:

• To propose standardized terminology for UVAs, differentiating congenital from acquired lesions.
• To outline current management approaches, particularly endovascular treatment, for UVAs.

Main Methods:

• Review of existing literature and clinical experience with uterine vascular anomalies.
• Proposal of a standardized classification system for UVAs.
• Description of a recommended endovascular approach using uterine artery embolization.

Main Results:

• Uterine artery embolization is the generally accepted first-line treatment for symptomatic UVAs, demonstrating high success rates.
• A proposed initial embolization technique involves targeting the dominant uterine artery, with options for contralateral embolization if needed.
• Repeat embolization is effective for recurrent UVAs, highlighting the importance of follow-up.

Conclusions:

• Standardized terminology is crucial for consistent diagnosis and management of UVAs.
• Endovascular treatment, specifically uterine artery embolization, is effective, but consensus on optimal techniques is lacking.
• A multidisciplinary, individualized approach is essential for managing symptomatic UVAs due to the absence of definitive guidelines.