title: Vascular changes responsible for the reduced effectiveness of obliteration of uterine arteries in women with advanced cervical cancer.
abstract: BACKGROUND
  Haemorrhages from the genital tract remain a major threat to the life of patients with advanced cervical cancer. It is possible to achieve haemostasis by both surgical techniques and the procedure of endovascular uterine artery embolization. However, in some women with loco-regionally advanced cervical cancer the obliteration of the uterine arteries is not effective.
  
  
  OBJECTIVE
  Evaluation of morphological changes in uterine arteries in patients with advanced cervical cancer and comparison of their changes with the achieved haemostatic effect of obliteration.
  
  
  METHODS
  The prospective study included a group of 8 women with cervical cancer at a clinical stage of IIB to IIIC according to the FIGO classification. 3D quantitative coronary angiography (QCA) was performed before uterine embolization. The haemostatic effect of uterine artery embolization was compared with observed vascular changes.
  
  
  RESULTS
  Mean uterine artery length in patients who achieved complete hemostasis: 39.5 mm - right uterine artery; 38.7 mm - left uterine artery. Mean uterine artery length in patients who achieved partial satisfactory haemostasis: 32 mm - right uterine artery; 30.5 mm - left uterine artery. Mean uterine artery length in patients who achieved unsatisfactory haemostasis: 10.5 mm - right uterine artery; 19 mm - left uterine artery.
  
  
  CONCLUSIONS
  Shortening of uterine arteries worsens prognosis of the haemostatic effect of their obliteration in patients with advanced cervical cancer.
authors.affiliation: Institute of Obstetrics and Medical Lifesaving, University of Rzeszow, Rzeszow, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Raba
authors.affiliation: Hospital, Przemysl, Poland.
authors.forename: Kamil
authors.initials: K
authors.lastname: Szczupak
authors.affiliation: Hospital, Przemysl, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Stabiszewski
authors.affiliation: Hospital, Sanok, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Skibinski
keywords: 3D angiography; cervical cancer; quantitative coronary angiography (QCA); uterine embolisation