Author + information
- Tasheva Iveta1,
- Ivo Petrov2,
- Zoran Stankov2,
- Silvia Alexandrova Pavlova2 and
- Galina Georgieva Kozareva2
The aim of our study was to evaluate the efficiency and safety of a minimally invasive procedure for treating uterine fibroids trough brachial access. The early and medium-term (5 years) results in recent studies show that uterine embolization is as effective as surgery (hysterectomy or myomectomy) for symptom control and quality of life improvement.
The group of patients includes 20 women with an average age of 23.9 years (interval between 31 and 47 years) with a period of follow-up between 6 and 12 months. All patients are referred by a gynecologist with proven multiple or single intramural fibroids. They present with symptomatic uterine fibroids (abnormal vaginal bleeding, abnormal menstrual pain, or abnormal pelvic pain), despite optimal medical treatment. Before and after the intervention, all patients underwent a CT of the abdomen and pelvis or MRI for better visualization of size, number, and location of the fibroids. In all patients, a 5 Fr left brachial access was used. The embolization of both uterine arteries was done with microparticles of size between 700-900 μm. Follow up was done respectively on 1st, 3rd, 6th and 12th month with verification visits by a gynecologist with ultrasound of the abdomen and pelvis, comparing the size of the fibroids and uterus volume. MRI was performed on the 6th month.
The results demonstrate high fibroid devascularization and volume reduction rates, improvement of hypermenorrhea and dysmenorrhea. The initial average diameter of the fibroids was 55 mm. On the 12th month, the reduction was to 30 mm. Furthermore, the quality of life and general health status by the patients' own assessment have increased. We did not observe serious early and late complications.
The brachial approach is feasible for uterine embolization. The procedure is a safe and effective alternative to hysterectomy. The initial results of our clinical experience are encouraging.