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Outcomes in Adenomyosis Treated with Uterine Artery Embolization Are Associated with Lesion Vascularity: A Long-Term Follow-Up Study of 252 Cases

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Journal PLoS One
Date 2016 Nov 3
PMID 27806072
Citations 11
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Abstract

Purpose: To study the therapeutic effects of uterine artery embolization (UAE) on adenomyosis and to investigate the association between uterine blood supply and artery embolization treatment outcomes.

Methods: Using digital subtraction angiography (DSA) imaging data, we retrospectively evaluated the vascular features of 252 adenomyosis patients treated with UAE. The cases were classified based on the equality of uterine blood supply (equal and unequal subgroups) and the degree of vascularity at the adenomyosis lesion site (hypervascular, isovascular and hypovascular subgroups). Patients were followed-up for 5 years after UAE. Improvements in dysmenorrhea and menorrhagia were evaluated based on the relief of the patients' symptoms. The improvement rates among the different subgroups were analyzed and compared.

Results: The improvement rates of dysmenorrhea and menorrhagia were 74.0% and 70.9%, respectively, at the short-term (12-month) follow-up and 70.4% and 68.8%, respectively, at the long-term (5-year) follow-up. No statistically significant differences were observed in the improvement rates for dysmenorrhea or menorrhagia between the equal and unequal blood supply subgroups at either the short- or long-term follow-up. The improvement rates for dysmenorrhea among the hypervascular, isovascular and hypovascular subgroups were 86.5%, 71.8% and 58.8%, respectively, at the short-term follow-up (p = 0.002) and 83.6%, 67.3% and 52.8%, respectively, at the long-term follow-up (p = 0.005). The improvement rates for menorrhagia in the hypervascular, isovascular and hypovascular subgroups were 81.0%, 68.3% and 60.7%, respectively, at the short-term follow-up (p = 0.024) and 79.4%, 61.4% and 62.2%, respectively, at the long-term follow-up (p = 0.052).

Conclusion: UAE is effective in treating patients with adenomyosis in both the short and long term. The outcomes of patients with adenomyosis were significantly correlated with lesion vascularity.

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References
1.
Kim M, Kim Y, Kim H, Cho J, Kang H, Lee C . Uterine artery embolization for symptomatic adenomyosis: a new technical development of the 1-2-3 protocol and predictive factors of MR imaging affecting outcomes. J Vasc Interv Radiol. 2011; 22(4):497-502. DOI: 10.1016/j.jvir.2011.01.426. View

2.
Toh C, Wu C, Tsay P, Yeow K, Pan K, Tseng J . Uterine artery embolization for symptomatic uterine leiomyoma and adenomyosis. J Formos Med Assoc. 2003; 102(10):701-6. View

3.
Bratby M, Walker W . Uterine artery embolisation for symptomatic adenomyosis--mid-term results. Eur J Radiol. 2008; 70(1):128-32. DOI: 10.1016/j.ejrad.2007.12.009. View

4.
Lohle P, de Vries J, Klazen C, Boekkooi P, Vervest H, Smeets A . Uterine artery embolization for symptomatic adenomyosis with or without uterine leiomyomas with the use of calibrated tris-acryl gelatin microspheres: midterm clinical and MR imaging follow-up. J Vasc Interv Radiol. 2007; 18(7):835-41. DOI: 10.1016/j.jvir.2007.04.024. View

5.
Kitamura Y, Allison S, Jha R, Spies J, Flick P, Ascher S . MRI of adenomyosis: changes with uterine artery embolization. AJR Am J Roentgenol. 2006; 186(3):855-64. DOI: 10.2214/AJR.04.1661. View