[Recourse to particular arterial embolization in the treatment of some uterine leiomyoma].
In 88 women between the ages of 34 and 51 years with one or several symptomatic uterine leiomyomata (menometrorrhagia, mass syndrome) after failure of medical treatment, particulate arterial embolization was proposed as an alternative to the scheduled surgical operation. Free-flow embolization with Ivalon particles (150 to 600 microns) was performed under local anaesthesia after femoral artery puncture and catheterization of the hypogastric then uterine arteries (5 F catheter) including occlusion Pelvic pain was frequently observed immediately after embolization, lasting 12 to 18 hours, and required analgesia. Necrobiosis syndromes can be observed in the case of very large leiomyomata. No immediate complications directly related to vascular catheterization were observed in this series, but complete necrosis of a very large leiomyomatous uterus required hysterectomy. Five embolization failures were observed. The following results were observed in the 80 interpretable cases with a follow-up of 6 to 60 months: the menstrual periods returned to normal in 60 (89%) of the 67 menorrhagic patients, after six months a volume reduction of myomata equal to 69% of initial volume was observed.


CONCLUSIONS
in of 80 interpretable cases, embolization constituted an alternative to surgical treatment, which was avoided in 71 cases, 9 failures were observed. The results of this preliminary series must be valited by further studies.
Ravina
J H
JH
Service de Gynécologie Obstétrique, CHU Lariboisière, Paris.
Bouret
J M
JM
Ciraru-Vigneron
N
N
Repiquet
D
D
Herbreteau
D
D
Aymard
A
A
le Dreff
O
O
Merland
J J
JJ
Ferrand
J
J
D000328:Adult; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000628:therapy*; D008863:Microspheres; D008875:Middle Aged; D014594:Uterine Neoplasms / Q000628:therapy*
Recours à i'embolisation artérielle particulaire dans le traitement de certains fibromyomes utérins.