Ovarian artery: angiographic appearance, embolization and relevance to uterine fibroid embolization.
OBJECTIVE
To describe the angiographic appearance of the ovarian artery and its main variations that may be relevant to uterine fibroid embolization.


METHODS
The flush aortograms of 294 women who had been treated by uterine artery embolization for fibroids were reviewed. Significant arterial supply to the fibroid, and the origin and diameter of identified ovarian arteries were recorded. In patients with additional embolization of the ovarian artery, the follow-up evaluation also included hormonal levels and Doppler imaging of the ovaries.


RESULTS
A total of 75 ovarian arteries were identified in 59 women (bilaterally in 16 women and unilaterally in 43 women). All ovarian arteries originated from the aorta below the level of the renal arteries with a characteristic tortuous course. Fifteen women had at least one enlarged ovarian artery supplying the fibroids. Fourteen women (14/15, 93%) presented at least one of the following factors: prior pelvic surgery, tubo-ovarian pathology or large fundal fibroids.


CONCLUSIONS
We advocate the use of flush aortography in women with prior tubo-ovarian pathology or surgery or in cases of large fundal fibroids. In the case of an ovarian artery supply to the fibroids, superselective catheterization and embolization of the ovarian artery should be considered.
Pelage
J P
JP
Department of Body and Vascular Imaging, Hôpital Lariboisière, AP-HP, 2 rue Ambroise Paré, F-75475 Paris cedex 10, France. jean-pierre.pelage@lrb.ap-hop-paris.fr
Walker
W J
WJ
Le Dref
O
O
Rymer
R
R
D000328:Adult; D000792:Angiography; D015415:Biomarkers / Q000097:blood; D002406:Catheterization, Peripheral; D018618:Echocardiography, Doppler, Color; D004621:Embolization, Therapeutic; D004867:Equipment Design; D004958:Estradiol / Q000378:metabolism; D005260:Female; D005640:Follicle Stimulating Hormone / Q000378:metabolism; D005500:Follow-Up Studies; D006801:Humans; D007889:Leiomyoma / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D007986:Luteinizing Hormone / Q000378:metabolism; D017537:Mesenteric Artery, Inferior / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D010053:Ovary / Q000098:blood supply* / Q000000981:diagnostic imaging; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D012307:Risk Factors; D012720:Severity of Illness Index; D013223:Statistics as Topic; D013997:Time Factors; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D016387:Women's Health
D015415:Biomarkers; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone