Embolization where. Uterine artery embolization as a method of treating uterine fibroids. Endovascular treatment procedures

Benign tumor, which grows due to connective tissue and develops in the uterine cavity, the walls of the organ or in the cervix, is called fibroids.

After 35 years, almost half of the female population faces this disease.

Signs of the disease may not appear immediately, but only after the tumor significantly increases in size.

Uterine fibroids have tumor characteristics, however, it is more correct to consider it not a tumor, but a tumor formation.

Causes of fibroids

The benign nature of myomatous nodes does not reduce the problems and dangers of formation, since fibroids are often accompanied by bleeding and problems with conception and miscarriage.

The more advanced the disease, the more difficult it is to treat, so it is necessary to diagnose fibroids as early as possible. The formation of fibroids begins with the mutation process of one cell; it is influenced by a disruption in the balance of hormones - an imbalance of progesterone and estrogen.

IN menopause Estrogen production decreases, which in most cases leads to degradation and complete loss.

The reasons for the occurrence of a myomatous node lie in the following:

imbalance of hormones;
lack of regular sex life;
ovarian diseases;
stress;
inactive lifestyle and heavy physical activity;
chronic infectious diseases;
diseases of the endocrine glands;
disruptions in lipid metabolism;
mechanical injuries - abortions, traumatic births, curettage, consequences surgical intervention;
genetic factor.

NOTE!

Scientists have proven that women who have had a history of childbirth are less susceptible to developing myomatous formations. However, late pregnancy and childbirth are rather a provoking factor, rather than a factor reducing the likelihood of developing the disease.

Modern methods of treatment

Treatment may be:

combined.

Removal of the uterus during menopause is most often performed with simultaneous removal of the ovaries. This is due to the prevention of oncological processes in the reproductive system.

Uterine artery embolization

Gynecologists have been using EMA in their practice for a long time - since the 80s of the last century.. Initially it was used to stop bleeding after childbirth or during surgery. After 10 years, the method began to be used to treat myomatous formations.

The procedure is carried out using a microsurgical technique, therefore it is low-traumatic. The mechanism of the procedure is to block the vessel that feeds the tumor cells. Accordingly, the cells die, and the node itself begins to degrade.

In Russia, such operations began to be carried out in 2001; before that, almost all patients had their fibroids removed with a scalpel, and sometimes along with the uterus. The innovative technique made it possible to save female organs intact, which allows you to get pregnant safely, carry and give birth to a healthy baby.

Advantages and disadvantages

The first and most important advantage of such an operation is certainly the preservation of the patient’s reproductive function.

In addition, embolism for fibroids has the following advantages:

no scars;
the procedure is carried out without the use of anesthesia;
efficiency is 95%;
the patient’s condition begins to improve literally immediately;
hospital stay no more than 24 hours;
the risk of relapse is significantly lower than after surgery.

Among the disadvantages of EMA are the following::

equipment for carrying out such manipulations is quite expensive, so not all clinics can afford to install it;
lack of specialists who can carry out such manipulations;
X-ray exposure that the patient receives during the procedure. Although this point cannot be called a significant drawback, since the radiation dose during UAE is similar to a fluorographic examination,
impossibility of collecting biological material for biopsy. But this drawback is completely eliminated by angiography;
high price.

Indications

Embolization can be used strictly according to indications. The main indication is to save the patient’s life.. If the uterus is constantly bleeding heavily, this can threaten the woman's life.

In addition, the indications for embolization are as follows::

desire to become a mother in the future;
Mima is large in size and is actively growing;
contraindications for other surgical procedures;
the patient’s desire to maintain the integrity of the uterus.

Sometimes embolization is performed immediately before surgery. Immediately after UAE, the myomatous formation is removed. This reduces the risk of bleeding to a minimum.

How is the operation performed?

The entire procedure takes from 30 minutes to 1.5 hours. It is carried out either in the operating room, which is equipped necessary equipment, or radiography room.

The steps of the procedure are as follows:

Local anesthesia. If the patient wishes or as prescribed by the doctor, epidural anesthesia can be used.
Insertion of a catheter into the cubital vein.
Treating the future puncture site with antiseptics.
Insertion of a catheter into the femoral artery. A probe is inserted through a small incision.
Injection of a contrast agent so that the vessels are visible on X-ray equipment.
After the catheter penetrates the vessels that provide nutrition to the tumor, the embolic substance itself is injected directly - as a rule, these are balls. This procedure is carried out with all existing myomatous nodes. The injected balls cause blockage of the arteries, as a result of which the blood flow through them stops.
Angiography is performed to confirm that the blood supply to the tumor has been cut off.
The catheter is removed, and a pressure bandage is applied to the puncture site for a day.
The patient is transferred to the ward, as she will need complete rest and medical supervision for the next 12 hours.

Contraindications

Contraindications to such a procedure are:

the presence of negative reactions to contrast radiological drugs;
malignant processes in the uterus or ovaries;
renal failure;
coagulopathies;
pregnancy;
acute infectious processes in the uterus and appendages;
radiation treatment;
autoimmune connective tissue diseases.

Preparing for surgery

Before performing UAE, the patient must complete a course of hormone therapy prescribed by the doctor. The effectiveness of the method decreases when taking hormonal drugs.

If a woman takes any other medicines, the doctor must know about this.

Most will need to be canceled about a week before your procedure.

You also need to pass the following tests:

blood test for protein, sugar, coagulability, electrolytes, liver and kidney diseases;
blood test for hepatitis, HIV and syphilis;
clinical urine analysis;
vaginal smear;
scraping from the cervix;
Ultrasound and, if necessary, MRI of the pelvic organs;
cardiogram.

Directly on the day of the manipulation, it is better to refuse breakfast; you should stop drinking water a couple of hours before the intervention. The woman is hospitalized the day before the scheduled procedure.

Complications

After the procedure, a woman may experience the following complications::

Hematoma in the area of the femoral artery - resolves on its own or with the help of special ointments.
Infection - stops antibacterial drugs. A temperature that does not decrease for several days after the procedure is a serious reason to consult a doctor.
Pain in the uterine area is relieved with analgesics. In fact, this is a normal phenomenon associated with the death of tumor cells, which, like ordinary cells of the body, have contact with nerve endings.
Intoxication processes are eliminated with anti-inflammatory drugs. This phenomenon indicates the body’s reaction to the contrast agent and directly to the embolization drug.
The appearance of adhesions is a rare complication that occurs in no more than 4% of cases.
Absence of menstruation - the cycle will recover on its own after some time.
Ovarian depletion is observed in 12-14% of cases.

Recovery period

After discharge from the hospital, a woman is prohibited from engaging in heavy physical labor or visiting baths and saunas for a week. A week later, the first ultrasound is performed, and a month after the procedure, an ultrasound is performed a second time. Subsequent treatment tactics depend on test results and the response of the myomatous formation to UAE.

Embolization for cancer is a minimally invasive method of treating cancer; it is used for many types of cancer, but in most cases for malignant tumors of the liver. The purpose of the procedure is to clog (close) blood vessels, feeding the oncological focus. Without blood circulation, atypical cells stop spreading, which leads to tumor shrinkage, destruction and death.

Embolization for cancer is a modern progressive method of combating metastases in hard-to-reach places when surgical removal tumors presents certain difficulties. The technique is actively used for large tumor formations, during preparation for surgery.

Types of embolization

Embolization for cancer is carried out in three ways:

Arterial or transarterial (TAE) embolization – used for tumors of the liver and uterus. A catheter is inserted into the artery, through which an embolic agent is supplied, leading to obstruction of the vessel.
Chemoembolization - a combination of TAE and chemotherapy is carried out in one of two ways. The first is that cytostatics are pre-coated with particles of an embolic agent. Second, a chemotherapy drug is injected into the artery through a catheter, then the lumen of the vessel is blocked.
Radioembolization - a combination of embolization and radiation involves the delivery of microspheres (radioactive particles) into the artery, which settle near the tumor site, releasing radioactive radiation over several hours or days.

Embolization for cancer is used in three options:

The main independent method of treatment.
– at the last stages of the oncological process to eliminate pain syndrome, stopping bleeding, reducing side effects and complications of the disease.
Preoperative embolization - used for large tumor volumes to reduce its size and improve surgical access, as well as to reduce blood loss during surgery.

It is used both as a separate method and as part of complex treatment, combined with radiation or chemotherapy

Advantages and disadvantages

Embolization for cancer is a promising alternative to surgery in oncology due to its advantages:

Low-traumatic technology that does not leave scars, like after surgery.
Minimal risk of infection and other complications.
No bleeding after the procedure.
No special need to use general anesthesia. This is especially true for individuals with drug intolerance.
Recovery in the shortest possible time.
High efficiency.
Preserving tissue integrity.
Possibility of use in inoperable forms of cancer.
Minimal toxic effects.
Possibility of selecting doses of the embolic agent individually, depending on the type of neoplasm, location, stage.
The likelihood of side effects is minimized.
Long hospitalization is not required.
The ability to carry out manipulation several times until a therapeutic effect is obtained without harm to other organs and the body as a whole.

The disadvantages of embolization are few. The procedure is prescribed individually and is not suitable for all cases. The manipulation must be carried out by a highly qualified, experienced specialist. If the surgeon is inexperienced, the embolus can penetrate healthy tissue and lead to complications.

Embolization for some types of cancer

Chemoembolization is effective due to anatomical features. The branches of the hepatic artery supply blood to liver tumors. Transarterial embolization occludes the branches without disrupting the functioning of healthy tissues that are supplied with blood from another source (portal vein branches). For some types of liver tumors, you can expect a complete recovery with TAE.

Embolization for cervical cancer is often combined with chemotherapy and radiation therapy, includes three stages. The first stage is two courses of chemotherapy. The second stage - bilateral embolization of the uterine arteries for cervical cancer, is carried out a day or two after the second course of chemotherapy in the X-ray operating room. The third stage – a week after TAE, irradiation is performed. The disadvantage of this method is the systemic effect of the cytostatic on the body.

Embolization is indicated when the patient has hemoptysis, or there are contraindications to surgery or radiation. For mechanical occlusion, microscopic fibers of Teflon velor are mainly used. For chemical - hypertonic solution or ethanol. Embolization of bronchial arteries is carried out for hemostatic purposes and for the purpose of introducing chemotherapy into the tumor area. Improvement is observed in 90% of patients.

Embolization for kidney cancer is indicated when it is impossible to carry out a full surgical intervention for one reason or another. Through a catheter connected to the vessels of the affected kidney, an embolus (gelatin-like plastic ball) is introduced, which clogs the vessel. Tumor development slows down or stops completely. When the patient's condition allows nephrectomy. In some cases, the technique is used before surgery to reduce the level of blood loss.

Indications and contraindications

Embolization is used in various fields of medicine, e.g. vascular surgery veins lower limbs, in gynecology for uterine fibroids, but in oncology this technique is considered experimental. There are not yet sufficient studies or long-term prognoses, so the possibility of performing this minimally invasive operation is considered for each patient individually.

Restrictions on the procedure are related to a specific diagnosis. Contraindications are mainly relative:

Hepatitis, cirrhosis.
Decompensated renal, hepatic, cardiac, respiratory failure.
Venous bleeding from varicose veins.
Bronchopulmonary embolism.
Volumetric decay cavities in the cancer focus.
Inability to securely fix the catheter.
Generalized oncological process.
Intolerance to radiopaque contrast agents.
Anomalies of the arteries.
Acute infectious process.
Pregnancy.
Diseases associated with blood clotting disorders.
Operable uterine cancer.

The question of the advisability of embolization is decided on a case-by-case basis and depends on the patient’s condition.

Carrying out embolization

Embolization for cancer is performed mainly on an outpatient basis. A preliminary diagnosis is carried out. Main method examinations - angiography with contrast, which allows you to assess the condition of blood vessels and identify the sources of blood supply to the cancer focus.

No special preparation is required, but the patient should not eat or drink 4–5 hours before surgery. To perform the manipulation general anesthesia It is rarely used, more often local anesthesia is used. After anesthesia, the artery is pierced in the right place, a microcatheter is inserted, through which the embolus is triggered. The following are used as embolic materials:

Liquid substances are convenient because they freely penetrate through vascular branches.
Glue-like substances - turn into a polymer after reacting with ions.
Viscous materials are used as chemoembolization mainly for liver cancer.
Sclerosing agents - compact the endothelium and are used for embolization of small vessels.
Microparticles are needed for the occlusion of small vessels.
Gelatin sponge or gel foam - causes temporary blockage.
Acrylic microspheres – cause permanent occlusion.
Spirals lead to instant thrombus formation.

To prevent complications after embolization, it is carried out against the background of antibiotic therapy.

Embolization effectiveness

According to studies and observations, if the procedure was successful and it was possible to block the vessel through which the tumor circulates, the patient begins to feel better and there is a decrease in pain. In some patients, the pain goes away quite quickly if it is possible to completely block all the vessels feeding the tumor. In some cases, if the formation receives blood supply from several branches or the collaterals are well developed, manipulation is ineffective.

The effectiveness of embolization is assessed according to the following criteria:

Complete regression – disappearance of disease manifestations, recovery.
Partial regression – a decrease in the size of the cancer lesion by 50% or more, the absence of other lesions.
Stabilization – the volume of the affected organ is reduced by less than half, there are no new lesions.
Progression – an increase in the volume of the affected organ by 25% or more, the appearance of new cancer foci.

Failure of embolization may be due to anatomical features, the form of a cancerous tumor, the doctor’s lack of experience. Some types of tumors, when metastasized, can transform into a rapidly growing form, so a thorough examination of the patient should be carried out before the procedure.

The embolization method is being studied and tested by medical researchers different countries. Experts believe that soon with the development of microendoscopic technology, it will be possible to use it to treat cancer different localizations. Already in the leading cancer centers To visualize the bloodstream, the latest equipment is used, operating on the principle of MRI in real time. This makes the procedure easier and more effective.

Embolization is one of the modern non-surgical methods for treating many diseases. What kind of procedure is this and what diseases it is used to treat will be discussed below. Embolization is considered a minimally invasive treatment method, an alternative to surgery, the essence of which is to block one or more blood vessels or channels.

The purpose of the procedure is to prevent blood supply to certain tissues, organs, structures to reduce the size of the tumor or block the aneurysm.

Before prescribing embolization, the doctor takes into account the patient’s age, the size and location of the tumor and nodes, and the severity of the manifestations.

The main indications for the procedure are:

Stopping bleeding:

after an unsuccessful operation;
after childbirth;
nosebleeds;
with aneurysm of cerebral vessels;
arteriovenous malformations;
in the esophagus

Treatment of tumors:

uterine fibroids;
kidney damage;
malignant neoplasms of the liver.

In addition, portal vein embolization is performed before liver resection.

Uterine artery embolization

The result of embolization of the uterine arteries is ischemia

The essence of this method is to block the uterine arteries, which results in the cessation of nutrition to the tumor nodes and their further death. After all, the uterine arteries are the only source of nutrition for fibroid nodes. During the procedure, special particles are injected into the vessels. As a result, the blood supply to the fibroid is stopped, ischemia of its nodes, necrosis and subsequent degeneration occurs.

Embolization of cerebral aneurysm

This procedure allows you to disconnect the damaged vessel from blood circulation without opening the skull. To do this, a catheter is inserted through the veins or arteries and advanced along the circulatory system until it reaches the aneurysm. Then the vessel is disconnected from the circulatory system using special instruments.

Embolization of liver vessels

Blood reaches the liver from two sources. It enters the healthy organ through the portal vein. And cancer cells usually feed from the hepatic artery. In malignant liver tumors, the hepatic artery becomes blocked and as a result, the cancer cells die. Besides, this method widely used in varicose veins veins

Contraindications to embolization

The embolization procedure is not prescribed in the following situations:

pregnant women;
for treatment malignant neoplasms uterus, with the exception of inoperable tumors;
in case of intolerance to the administered drugs;
during acute inflammatory processes in the genitourinary organs;
the presence of blood clotting pathologies;
when the patency of the arteries is impaired.

The essence of embolization

The operation is performed using a minimally invasive method

Embolization is carried out in a cath lab with an angiography machine. The procedure is performed by an endovascular surgeon under local anesthesia.

The procedure includes the following steps:

A small puncture of the skin is done.
A thin catheter is inserted into the artery.
First, an iodide contrast agent is injected through the catheter and an x-ray is taken to ensure that the catheter is in the right place.
Then an embolization drug is injected through the catheter, blocking the vessels that feed the tumor.
The procedure is completed by control angiography, which makes sure that the tumor is drained of blood.
The doctor removes the catheter from the artery and closes the puncture site with a special device.

The operation is almost painless and can last from 10 minutes to 2.5 hours, depending on the complexity. Typically the duration of the procedure does not exceed 20 minutes. Embolization of an aneurysm or portal vein is performed under general anesthesia.

Advantages of embolization:

the uterus and reproductive function are preserved;
a minimally invasive safe method that does not require general anesthesia;
low risk of complications;
allows you to quickly and effectively get rid of the problem;
there are no relapses;
short rehabilitation period.

The disadvantages of embolization include:

Low information content compared to classical methods.
Impossibility of performing a biopsy of fibroid nodes.
High price.

Drugs used

Special embolization agents are used during surgery

Embolization is a minimally invasive procedure that requires the use of a sophisticated instrument.

The intervention kit includes:

embolic agent;
catheters and microcatheters;
puncture instrument;
hydrophilic conductors;
introducers.

Let's look at commonly used embolic agents:

Non-spherical particles of polyvinyl alcohol PVA are a commonly used product. Manufacturer USA. The particles are characterized by irregular shape and inaccurate sizing. There is a risk of particle aggregation, inflammation and insufficient embolization.
Bead Block spherical embolization spheres are capable of penetrating small bore catheters. Produced in Japan. The drug causes almost no inflammation.
Spherical Embozene particles. Made in the USA. It is considered a modern drug. Particles correct form and exact size. The drug does not cause inflammation.

Sclerosing materials are also used to seal the endothelial lining of blood vessels:

Ethanol. I use it to treat arteriovenous malformations. In large quantities, ethanol is toxic to the body. In addition, injections with this substance are painful.
Ethanolamine oleate. Used for procedures on varicose veins of the esophagus. In large doses it can lead to the development renal failure or hemolysis.
Sotradecol is used in procedures for varicose veins.

To carry out mechanical blockage, the following materials are used:

Embolic coils. Used for aneurysms, injuries, arteriovenous malformations;
Removable cylinders. Used for arteriovenous malformation and aneurysm.

The use of the above drugs allows embolization to be carried out with high accuracy and efficiency.

Possible complications

The embolization procedure is carried out under X-ray control.

The most common complications after surgery are:

the appearance of a hematoma in the puncture area;
temporary menstrual irregularities;
development of new fibroid nodes;
pathology, infectious nature.

In addition, arterial thrombosis and uterine necrosis may develop. However, if all technologies are followed, embolization performed by an experienced specialist will reduce the risk of complications.

Recovery

After surgery, you must follow proper nutrition and drinking regime

After the procedure, the patient may feel slight pain. The pain usually goes away within 8 hours. To alleviate the condition, the doctor prescribes painkillers. For a month painful sensations may occur as a result of hypothermia, overwork, or after lifting heavy objects. The temperature may rise and slight bleeding may appear.

A woman may notice weakness and fatigue. For a quick recovery, doctors recommend adhering to the following rules:

increase the amount of fluid consumed;
for several weeks do not take hot baths and avoid visiting the sauna;
do not engage in physical activity for a month;
Avoid sexual intercourse for a month.

The first menstruation after the intervention may be painful and occur with the presence of blood clots. Then everything will return to normal, the amount of bleeding will decrease, and the cycle will regulate. After a month, the uterus will decrease in volume. Complete disappearance of the tumor can take up to six months. In most cases, after embolization there is no need for additional treatment.

Embolization is an effective, low-traumatic method and an alternative to surgery.

After treatment, for example, during the treatment of fibroids, the uterus continues to function, and the woman’s reproductive function is preserved. According to statistics, up to 94% of women get rid of the tumor.

From this video you can learn more about uterine artery embolization:

The considered method of treating uterine fibroids is minimally invasive. After such a procedure, reproductive and menstrual functions persists, which is especially important for young women. Like any other operation, UAE has specific indications and contraindications, positive sides and disadvantages.

The essence of uterine artery embolization in the treatment of uterine fibroids - why is the operation performed?

The manipulation in question in some medical sources is also called embolization

The purpose of the procedure is blocking the blood flow to the fibroid, which favors its reduction. To do this, a microscopic particle is introduced into the uterine artery - embolus.

Often preference is given to emboli that are made of medical plastic. Although in practice, particles from other hypoallergenic and body-safe materials can be used.

After entering a blood vessel, this particle clogs its lumen, cutting off the flow of blood to the fibroid. At the same time, the uterus retains its viability: it is supplied by the ovarian arteries, and the muscle components of the fibroids, after a certain period of time, are replaced by connective tissue. Fibrous formations self-destruct over time.

Video: Uterine artery embolization (UAE) for uterine fibroids

UAE is used regardless of the number of pathological nodes and their parameters. Through this manipulation, you can significantly reduce the size of myomatous nodes, and in some cases, get rid of them altogether.

In extremely rare cases, additional therapeutic measures may be used.

Intervention in the patient’s reproductive system during this procedure is minimal.

In addition, if there were difficulties with conception due to fibroids, after embolization of the uterine arteries the woman has every chance of becoming pregnant.

Indications and contraindications for UAE

This procedure may be prescribed for the following conditions:

Large parameters of the uterus: as in women in the 9th or more weeks of pregnancy.
Heavy periods.
The patient's desire to maintain the viability of the uterus.
The presence of contraindications to surgical intervention, as well as to hormonal therapy.
Regular pain.
Malfunctions of the pelvic organs and/or their compression.
Diagnosis of multiple/single myomatous nodes, the diameter of which is no more than 8 cm. If the size of the pathological nodes is larger, the doctor may decide to perform UAE as a preparatory procedure before removing the fibroids using an invasive method.
Infertility caused by uterine fibroids.

This type of treatment cannot be prescribed for the following pathologies:

The period of bearing a child.
Infection of the body.
Serious problems with the liver and/or kidneys.
Allergic reactions to iodine-containing, radiopaque substances.
Inflammatory phenomena in the genital area.
Disorders associated with blood clotting.
A significant increase in the volume of the uterus (as in women at 20 weeks of pregnancy), associated with the gigantic diameter of the myomatous nodes.
Cancer of the uterus or a precancerous condition.
In addition, in the case of UAE in the presence of subserous nodes on a thin stalk, there is a risk of developing peritonitis in the future. Therefore, to treat such tumors, the doctor opts for other methods.

How uterine embolization is performed - video and stages of UAE surgery

Preparation for surgery:

5 days before the procedure, the patient should take antibacterial agents.
Women with a low pain threshold are prescribed sedatives, and on the day of UAE they are given an additional dose of painkillers.
On the day of surgery, you are prohibited from consuming any food or liquid.
You should also shave your groin area and bring elastic bandages or compression stockings.
At least two hours before surgery, the patient is given an intravenous infusion of an antibiotic to prevent infection of the body. Ceftriaxone is often used.

Video: Uterine artery embolization

Algorithm for uterine artery embolization:

The result of uterine embolization - what happens to the fibroids?

In the first few hours after surgery Myoma muscle cells die, which is accompanied by pain.
The most active reduction of pathological nodes is observed in the first six months after the manipulation in question.
Often in a year the uterus acquires normal parameters, and myomatous nodes are reduced by 4 times.

The speed and nature of regressive phenomena will be determined by the parameters and location of the nodes. If the specified nodes are located in the area back wall uterus, their size will decrease slowly. When localized close to the uterine cavity, pedunculated nodes can break off and migrate outward.

To control the process of fibroid transformation, you should undergo ultrasonography pelvic organs 3 months, six months and a year after embolization.

In the future, it is necessary to be examined by a gynecologist every 6 months in order to exclude relapse.

Video: Embolization of arteries of uterine fibroids

The patient needs rest for the first 8 hours after the procedure. The bandaged leg must be kept in a horizontal position, and an ice pack is applied to the site of manipulation for the first couple of hours. This helps reduce swelling and relieve pain.

The patient should wear compression garments on her legs for the first few days.

If there are no exacerbations, you are allowed to go home after 1-3 days. Before leaving the hospital, the doctor performs an ultrasound examination.

After embolization of the uterine arteries, the following phenomena may be of concern:

Slight increase in body temperature.
Prostration.
Pain in the lower abdomen. To eliminate them, painkillers are prescribed.
Nausea.
Vomit. This post-embolization syndrome is relieved with antiemetic therapy.
Bloody vaginal discharge. Menstrual cycle completely improves within 3 months after UAE.

Such phenomena can occur from several days to several weeks.

Within a month after this procedure, patients are prohibited from:

Visit saunas and long time stay in direct sunlight.
Undergo any physical procedures in the uterine area.
Engage in active sports.
Take baths.
Have vaginal sex.

Side effects with this procedure are extremely rare, but they do occur.

These include:

The appearance of a hematoma in the area of the artery puncture. None therapeutic measures it is not required to eliminate it - it resolves on its own.
Migration of the node into the peritoneum or uterus.
Embolization of nearby organs as a result of emboli entering the blood vessels that supply them. A similar condition can develop against the background of individual anatomical features.
Inflammatory processes in the uterus, accumulation of purulent masses in its cavity. These negative conditions can occur with extensive death of myometrial cells. In this case, the uterus is removed urgently.
Vaginal dryness, lack of sexual desire. Occurs when the cervicovaginal vessels are blocked.

Price of uterine embolization in Russian clinics

The cost of the manipulation in question will be determined by several factors:

Status medical institution. The amount for such an operation in public clinics often lower than in private ones.
Experience and authority of the surgeon.
The number of tests that the patient needs to undergo. If there are concomitant diseases, the examination will be more extensive, which means more financial resources will be spent.
Variety medical supplies, which must be drunk or punctured before embolization of the uterine artery.
The volume of dye for angiography.
Postoperative measures. This includes the number of days spent in hospital; list of instrumental and laboratory examinations; number of consultations with the doctor.

Embolization is a minimally invasive x-ray surgical procedure. It consists of selective occlusion (blockage) of blood vessels with specially introduced emboli.

Embolization is used to treat a wide range of pathologies of different organs:

arteriovenous malformations (AVM);

cerebral aneurysms;

gastrointestinal bleeding;

nosebleeds;

bleeding in the early postpartum period;

bleeding caused by unsuccessful surgery

neoplasms (treatment is used to slow or stop the blood supply to the tumor, which leads to a decrease in its size; the most common diagnosis is hepatocellular carcinoma);

kidney neoplasms;

uterine fibroids.

embolization of the portal vein (portal venous embolization) before liver resection surgery.

Embolization is a minimally invasive procedure that is an alternative to surgery. Treatment is aimed at preventing blood supply to certain organs, tissues, and structures of the body, which helps reduce the size of the tumor or block the aneurysm.

Embolization is performed endovascularly by a radiologist, using a unit for x-ray surgical (interventional) procedures. In most cases, it is performed with little or no pain relief, although this depends on the organ being treated. Procedures such as embolization of a cerebral or portal vein aneurysm are usually performed under general anesthesia.

Access to the embolized vessel is made using a catheter and a guide. After access to the vessel, the actual treatment begins. Typically, the following types of artificial emboli are used for this: spirals; particles; gelatin sponge (“gel foam”); cylinders; cylinders.

Liquid embolic materials used to treat AVMs can freely penetrate complex vascular branches, which is very convenient for the surgeon: there is no need to install a catheter in each individual vessel. Examples of such liquids are lipiodol, ONYX.

Mechanical occlusion devices are suitable for any vessel. In addition, their advantage is the possibility of precise placement: during installation, they are placed directly at the point in the vessel where the catheter ends.

Embolic coils can be used for arteriovenous malformations, aneurysms, and traumatic injuries. They are very suitable for vessels with intense blood flow as they cause immediate thrombus formation. Made from platinum or stainless steel. The spiral itself is not capable of causing mechanical occlusion, but its installation leads to thrombus formation, which is greatly facilitated by the polyethylene terephthalate (“Dacron”) fibers with which the metal of the spiral is entwined.

11. X-ray endovascular neurosurgery (embolization of aneurysms, selective thrombolysis).

Embolization of aneurysms, AVMs, varicose veins, tumors (including chemoembolization).

Diseases caused not by narrowing or stenosis, but rather by the appearance of new, pathological vessels or changes in healthy vessels, occupy a key position in X-ray endovascular neurosurgery. X-ray surgery allows you to embolize ("close", turn off from the blood flow) these vessels, thereby restoring normal blood flow and ensuring recovery.

Embolization of arterial aneurysms with microcoils. An aneurysm is an expansion of the artery wall under the influence of high blood pressure, hereditary and anatomical factors. Over time, it can suddenly rupture - a hemorrhagic stroke occurs. A modern, low-traumatic treatment method offered by x-ray surgery is embolization of an aneurysm with microcoils. The technique is as follows: using a microcatheter, the aneurysm cavity is filled with special metal spirals. They tightly seal the aneurysm, as a result of which the blood flow in it stops.

Treatment of vascular malformations of the brain is best done in the early stages, when the anomaly is small in size, in the absence of bleeding and other associated symptoms. Just as in the treatment of cerebral aneurysms, the treatment of a malformation consists of “switching off” it from the bloodstream through endovascular embolization, or its direct removal.

The technological breakthrough in the early 90s of the last century, associated with the emergence of microspirals and new types of microcatheters, along with the dynamic development of angiographic technology, gave impetus to the widespread use of the endovascular embolization method. This procedure is minimally invasive and is associated with minimal risk of complications compared to surgical treatment (associated with craniotomy).

Before the embolization procedure, angiography is performed - an x-ray method that allows you to determine the exact location of the aneurysm, after which the embolization procedure itself begins.

When performing an embolization procedure, the surgeon has the opportunity to access the surgical site through the vascular bed without opening the skull. In this case, the doctor uses a special technique that allows him to visualize the patient’s vascular network in real time using an X-ray surgical angiographic system and perform surgical intervention through the lumen of the vascular bed (artery). As with angiography, the embolization procedure begins with the insertion of a special catheter (a thin tube with a diameter of no more than 2 mm) into the femoral artery, followed by its passage through the arteries into the vessels of the brain to the body of the malformation.

Then a thin platinum thread - a “spiral” - is inserted into the malformation through a catheter, which blocks the blood flow in it.

Thrombolytic therapy.

The goal of thrombolytic therapy is to dissolve the blood clot that has closed the lumen of the vessel. Previously, drugs such as fibrinolysin, streptokinase, streptodecase and others were used for this purpose. However, their use was associated with a high risk of allergic complications. Therefore, a modern drug is currently used to dissolve a blood clot - tissue plasminogen activator (TPA). Tissue plasminogen activator is a powerful drug that not only thins the blood, but acts on the formed blood clot, dissolving it. This is very effective method, but it has one drawback - it is effective only in the first 3-4 hours, when the blood clot is “fresh”. In addition, the use of thrombolytic therapy may itself carry risks of certain complications. The main contraindications to such therapy are recent bleeding (gastric, intestinal, and cerebral hemorrhages, etc.).

Thanks to endovascular surgery, it has become possible to use intervention methods in the treatment of ischemic stroke.

Selective administration of thrombolytic. Acute (fresh) occlusion caused by thrombosis can be combated using selective thrombolysis. To do this, a special substance, a thrombolytic, is injected into the affected vessel, which dissolves the blood clot. With this technique, the drug is not injected into a vein, but directly into the affected artery of the brain. This allows the drug to have a greater effect on the blood clot that has blocked the lumen. For this administration of the drug, a thin catheter is inserted into the femoral artery, which, under X-ray control, is brought to the affected area. cerebral artery. This method allows the use of thrombolytic therapy somewhat later than with the usual method of administering the drug into a vein.

Mechanical removal of a blood clot (thrombectomy).

In some cases, direct removal of the thrombus from the artery lumen may be used. The procedure is carried out under X-ray control. A special catheter is inserted through the femoral arterial access, at the end of which there is a device in the form of a spiral. This spiral plays the role of a trap, which captures the thrombus and then, together with the catheter, is removed from the vessel. Mechanical removal of a blood clot shows good results in restoring blood flow in those patients for whom thrombolytic therapy is contraindicated for one reason or another.