Effect of selective uterine artery embolization on symptomatic uterine fibroids

Objective: To evaluate the outcomes of selective uterine artery embolization (SUAE) in treatment of symptomatic uterine fibroids using Color Doppler ultrasonography (CDUS). Methods: As the procedure SUAE for fibroids, prospective data of the initial 65 consecutive women treated from March 2007 to September 2009 were collected. The follow-up period from 1 week to 30 months, using questionnaires, we investigated the fibroid-related physical and psychological symptoms, and the cumulative rates of symptom control, gynecologic interventions, and complications. The volumes of uterine and uterine fibroids were calculated by CDUS pre- and post-SUAE for 6 months. And we tested the levels of internal hormone including FSH, LH and E2 before and after SUAE for 3, 6 months. Results: SUAE was performed successfully in all patients. There was no peri-operative morbidity in all procedures. Compared with pre-SUAE volumes of uterine [(322±112) cm3] and uterine fibroids [(125±46) cm3], their volumes in post-SUAE were (144±72) cm3 and (51±11) cm3 (P<0.01), and reduction rate was 58% and 61%, respectively. At 3, 6 months after SUAE, levels of FSH, LH, and E2 were not decreased than that of in pre-SUAE (P>0.05). After SUAE for 24 months, the fibroids related physical and psychological symptoms such as bleeding, pain and quality of life were significantly improved (P<0.01). 90.8% (59/65) women had resolution of symptoms and no significant post-procedural symptoms. Parts of patients discharge necrotic fibroids. 86% (34/40) complications were minor, requiring no therapy. 9.2% (6/65) had significant post-procedural symptoms, requiring therapy in hospital or out-patient department. Conclusion: SUAE contributes to a long-term significant improvement of all investigated uterine fibroid-related symptoms and markedly improves women's health-related quality of life. SUAE that no impair on changes of internal hormone, under suitable conditions, represents an attractive alternative to hysterectomy for the treatment of symptomatic fibroids and is a minimally invasive, new method of good clinical prognosis. CDUS is an effective to investigate the outcome of SUAE.

Interventional therapy for chronic simple atherosclerotic occlusive disease of lower extremity

Objective:To explore the efficacy of interventional therapy for chronic atherosclerotic occlusive disease of the lower extremity.Methods:Fifty-six cases of simple atherosclerotic occlusive disease of lower extremity were divided into 3 types according to the location of occlusion,including 17 cases of abdominal aorta-iliac artery,18 cases of iliac-femoral artery,and 21 cases of inferior popliteal artery.Catheter and guide wire combined with blunt dissection and subtle banding were used to dredge the occluded vessels,and stents were implanted when interlayer appeared.Results:After the treatment,46 cases of occlusion were dredged(82.1%),6 cases remained occluded with the same symptoms(10.7%),and 4 cases had severer symptoms(7.1%).Among the 46 successful cases,there were 16 cases of abdominal aorta-iliac artery(94.1%),16 cases of iliac-femoral artery(88.9%) and 14 cases of inferior popliteal artery.artery(66.6%).There was no statistical difference between the abdominal aorta-iliac artery cases and iliac-femoral artery cases(P>0.05),but there was statistical difference between these two types and the inferior popliteal artery cases(P<0.05).In the successful cases,9 cases of abdominal aorta-iliac artery(52.9%),10 cases of iliac-femoral artery(55.5%) and 10 cases of inferior popliteal artery(33.3%) had 5-10 cm of occlusion,with no statistical difference between the first two types(P>0.05),but with statistical difference between the first two types and the third type(P<0.05).Compared with the 14 dredged cases(71.4%),the 7 cases(33.3%) of inferior popliteal artery cases had richer compensatory circulation(P<0.05).Conclusion:It's safe and effective to treat simple atherosclerotic occlusive disease of the lower extremity with interventional therapy.The location and length of occlusion and the abundance of compensatory circulation had effect on the therapy.