Embolisation bei symptomatischen Uterus-Myomen (UAE): Technik, Indikationsstellung und Ergebnisse

Zusammenfassung:

Vorstellung der Indikationsstellung, der Technik und der Ergebnisse der Uterusarterienembolisation (UAE) bei symptomatischen Myomen. Interventionstechnische Voraussetzungen werden dargestellt, wie der Einsatz der DSA, der superselektiven Katheterisierung und der unterschiedlichen Embolisationsmaterialien wie Polyvinylalkohol (PVA) oder Microsphären, sowie Nachkontrollen nach UAE. Die technischen Erfolgsraten der UAE betragen zwischen 98 - 100 %. Die Ansprechraten liegen zwischen 85 - 94 % mit einem deutlichen oder kompletten Verlust der durch die Myome verursachten Symptomatik. Es wird eine Größenreduktion nach UAE von 48 bis zu 70 % der größten Myome erzielt. Bei Symptomen aufgrund der Größe der Myome erreicht man eine Besserung bei 85-96 %. Frauen die aufgrund von Menorrhagien mit der UAE behandelt werden, zeigen ein Ansprechen von 80 - 96 %. Die bisherigen Daten zur UAE belegen eine hohe Effektivität bei einer minimalen Komplikationsrate. Weitere Studien sind ausgerichtet auf die Langzeitergebnisse, den Einfluss auf die Fertilität und mögliche Spätkomplikationen.

Abstract

Presentation of indication, technique and results of transarterial uterine artery embolization (UAE) for the treatment of symptomatic myomas. Technical requirements are presented like DSA, catheters, superselective catheterisation and the different embolization materials as polyvinylalcohol (PVA) or microspheres, as well as the follow-up after UAE. The technical success rate of UAE is documented to range between 98 to 100 % and myomatous symptomatology disappears in 85 to 94 % of the cases. A reduction in the size of the myomata after UAE is observed between 48 to 70 %. A resolution of the hemorrhage disappears in 80 to 96 % of the cases immediately. Particulate embolization of the uterine artery is a new minimally invasive therapy in the management of symptomatic leiomyomas with a high efficiency and low rate of major complications. Further studies may prove the longterm results after UAE, the influence on fertility and possible late complications.

Key words

Leiomyoma - therapeutic embolization - uterus blood supply - treatment outcome

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