Uterine artery embolization for the treatment of uterine adenomyosis：comparison study of different embolic agents / 介入放射学杂志

ABSTRACT

Objective To investigate the clinical effects and complications of uterine artery embolization (UAE) therapy using different embolic agents in treating uterine adenomyosis. Methods During 2004—2011, a total of 45 female patients with uterine adenomyosis were admmitted to authors’ hospital to receive uterine artery embolization therapy. The embolic agents used in the procedures included domestic iodized oil, sodium alginate microspheres and Embosphere microspheres. The patients were randomly divided into group A (n=15, using domestic iodized oil as embolic agent), Group B (n=13, using sodium alginate microspheres as embolic agent) and group C (n = 17, using Embosphere microspheres as embolic agent). After the treatment, all the patients were followed up for over 2 years, focusing on the observation of the clinical symptoms such dysmenorrheal, changes of MRI signs and severe complications. The results were analyzed and compared among the three groups. Results After UAE, the clinical symptoms such as the degree of dysmenorrhea, menstrual quantity, etc. were improved in all patients. Six months after UAE, the obvious remission rate of dysmenorrheal in group A, B and C was 33.3% (5/15), 30.8% (4/13) and 41.1%(7/17) respectively. Twelve months after UAE, MRI scanning showed that the uterine sizes in group A, B and C were reduced to 49.19%, 48.25% and 50.05% respectively. Follow-up examination at 24 months after UAE showed that recurrence of dysmenorrheal in group A, B and C was seen in 2, 4 and 2 cases respectively, and amenorrhea was seen in 2 cases of group A and one case in group C. Conclusion The use of domestic iodized oil, sodium alginate microspheres or Embosphere microspheres as embolic agents in performing super-selective uterine artery embolization for adenomyosis can effectively relieve the degree of dysmenorrheal, decrease the uterine size. In addition to ovarian dysfunction, the uterine cavity adhesion may be also a possible cause of amenorrhea occurring after UAE may. In order to ensure a similar clinical efficacy, the use of granular solid embolic agent is preferred as its safety is possibly higher than the liquid embolic agents.