Arterial embolization in uterine myoma indications procedure result

Embolization of uterine fibroids does not require surgical intervention. The desired effect is achieved through the use of an intravascular substrate that can cause blockage of the vessel in myomatous nodes.

A catheter is inserted through a puncture in the right thigh, through which a substrate is introduced. A few hours after the procedure, the arteries of the myomatous node overlap and it dies.

The effectiveness of uterine artery embolization surgery for uterine myoma is so high that in a number of cases it allows to avoid surgical intervention to remove the uterus. This is especially true for young patients who are planning a pregnancy.

You can find out the cost of uterine artery embolization in Moscow at the CELT clinic in the corresponding section of our official website.

  • fibro >

A major role in deciding on embolization of the uterine arteries with uterine myoma is played by the patient’s desire to save the uterus and give birth and exclude surgery in the future.

Contraindications:

  • giant tumors that need to be removed by open access;
  • uterine vascular anastomoses with ovarian vessels in young women;
  • the development of the infectious process;
  • allergic reaction to contrast drugs.

How does EMA work?

Embolization allows you to mechanically clog the vessel and cause the formation of a blood clot. With myoma, this procedure is aimed at stopping the blood flow along those branches of the uterine arteries that feed the myomatous nodes. In this case, the branches that supply a healthy myometrium are not affected.

After the blood flow is stopped, the cells forming the fibroid die. Several days are required to replace them with connective tissue, after which it begins to absorb. The latter leads to a significant decrease, and often – to the complete disappearance of myomatous nodes.

This approach also eliminates the clinical manifestations of pathology.

For the first time in the Russian Federation, an EMA with radial access, i.e. through the artery to the hand or forearm. This approach has reduced the time of surgery, fluoroscopy, as well as the amount of contrast medium.

The work of the operator is also greatly facilitated, and the patient herself feels much more comfortable.

Moreover: according to numerous studies conducted around the world, radial access through the arm is much safer than access through the femoral artery, the risk of complications when using it is reduced by more than five times.

In our clinic, radial access is performed using original Japanese-made Terumo catheter probes. They are even thinner and smaller than the probes used to puncture the femoral artery, making the procedure even less traumatic. After it, the patient does not have to observe bed rest. An discharge from the hospital occurs the very next day.

Based on the numerous reviews of uterine artery embolization with uterine myoma, the procedure practically does not cause pain, which allows it to be performed under local anesthesia.

During an EMA, the patient may feel warmth or a slight burning sensation in the lower back and lower abdomen under the influence of the contrast medium needed to visualize the blood vessels.

The drug, which is used for embolization, is safe and biologically inert, and therefore will not cause an allergic reaction. For embolization, its amount is minimal and amounts to 500 mg.

It provides a puncture of the skin in the upper thigh on the right and the introduction of a special catheter into the artery, which the specialist carefully holds in the uterine arteries. The accuracy is achieved due to x-ray control. Microparticles of the embolization preparation are introduced through the catheter. The duration of the procedure is from ten minutes to two and a half hours, depending on the clinical case and the experience of a specialist. On average, it lasts about twenty minutes.

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How much?

The cost of uterine artery embolization in CELT is:

  • 72 thousand rubles – with access through the thigh;
  • 86 thousand rubles – with access through the wrist.

The price includes:

  • conducting EMA;
  • consultation with an anesthetist;
  • anesthesia;
  • stay and food in a hospital.

Additionally paid: the cost of emboli (depending on the number of ampoules used – from 1 to 3).

Immediately after the procedure, pain of a pulling nature occurs, localized in the lower abdomen. They last for several hours and are eliminated by taking analgesics. In the first few days after the procedure, the following manifestations may be observed:

  • fever;
  • increased white blood cell count;
  • bloody issues;
  • urination disorders;
  • nausea and vomiting.

Gynecologists at the CELT clinic recommend EMA as the most effective and safe way to treat uterine fibroids. It is included in an individual comprehensive treatment program for this disease and allows you to achieve the desired results in 99% of cases.

The risk of complications after EMA is minimal and does not exceed 1%. Perhaps a violation of the menstrual cycle, which is restored after 3-6 months. In addition, in 20% of cases with submucous myoma, a relapse of the disease and the birth of nodes is possible.

Ema in Celt

Uterine fibroid embolization in CELT is performed:

  • absolutely painless and safe with the use of effective anesthetics by experienced specialists;
  • effectively, with the use of modern embolizing agents that allow you to stop blood flow only in the vessels that feed the myoma;
  • low-impact, using modern techniques and equipment.

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Complications and failures of EMA in the treatment of uterine fibro >

EMA is carried out in a hospital hospital of a state or private clinic with specialized equipment. Before the procedure, the woman is examined in gynecology and takes medications that should suspend any inflammatory processes that are not identified during the examination.

2 specialists carry out embolization: an anesthesiologist and an endovascular surgeon. The progress of the procedure is constantly monitored by radiography.

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The average cost of treatment in Russian clinics ranges from 50 to 100 thousand. The price is largely determined by the qualifications and experience of the leading specialist, as well as the type of equipment used.

Among the patients’ reviews about the performed EMA of the uterus, there are both positive (most) and negative ones. Among the advantages of the procedure, women distinguish a short period of hospitalization and the result of treatment. They also note the superiority of EMA over surgical aesthetics – patients do not have stitches.

The main thing that patients indicate in positive reviews is the preservation of the ability to give birth to a healthy child and the almost complete absence of relapse of the disease.

It should be noted that some women describe severe pain during the intervention and are prone to prolonged postembolic syndrome, however, this is most often due to insufficient qualification of the surgeon or superficial examination. If the procedure is performed by an experienced doctor, then these unpleasant moments practically do not appear.

The most common symptom after embolization of the uterine arteries is pain in the lower abdomen in the first hours after the intervention (70-95%). The pain can last up to 14 days (the so-called post-embolization syndrome). This pain is associated with the cessation of blood flow in myoma and indicates necrotic changes in the tissues. All patients in this period should receive adequate analgesia, up to narcotic analgesics.

“Abnormal uterine bleeding”, K. V. Puchkov, V. V. Ivanov, I. A. Lapkina

Another feature of the postoperative period is a slight increase in temperature to 37,5 – 38 degrees within 5-10 days after embolization (a manifestation of the systemic reaction of the body to tissue ischemia and node necrosis), which requires the use of antibiotics and non-steroidal anti-inflammatory (NSAIDs) drugs. Also, in connection with intoxication, patients note nausea and vomiting.

In each of the large published works, cases of amenorrhea (absence of menstruation) were observed in 2-7% of patients (Goodwin S., McLucas B. et al., 1999; Pelage J., LeDref et al., 2000).

Depletion of ovarian function was observed with a frequency of up to 14%.

The frequency of emergency hysterectomies (removal of the uterus) due to complications of EMA is 0,3-1%. This is due to necrosis of the node and the development of peritonitis. Especially often, this type of complication occurs during EMA with the location of nodes superficially (subserous localization).

In 2-4%, development of endometrial necrosis occurs with the subsequent formation of synechia in the uterine cavity and infertility. The phenomena of postischemic endometritis with the development of infection in the uterine cavity are more common.

A common complication is the formation of a hematoma (bruise) at the site of an artery puncture (20%). As a rule, this does not require additional treatment and passes on its own within two weeks.

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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