Features of Angioarchitectonics of Uterus in Uterine Leiomyoma: a Series of Clinical Observations

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Abstract

INTRODUCTION: One of most important problems in the gynecological practice is the choice of the treatment method of uterine leiomyoma. Uterine artery embolization has been practiced in the Republic of Tatarstan (Kazan), since 2004. Individual peculiarities of blood supply to the uterus and ovaries become the cause of failure of the endovascular treatment of patients with uterine leiomyoma in 20%–25% of cases forcing the doctors to resort to traditional surgical methods. The article presents a series of clinical cases demonstrating variants of angioarchitectonics of uterus and the results of the analysis of uterine artery embolization (UAE, n = 1743) performed at the department of X-ray surgical methods of diagnostics and treatment in the Primary healthcare unit of Kazan (Privolzhsk) Federal University.

CONCLUSION: Endovascular occlusion of uterine arteries in patients with uterine myoma is a fairly effective method of treatment of this disease, and an adequate assessment of the peculiarities of the angioarchitectonics of uterus in uterine myoma permits to considerably increase the effectiveness of treatment and reduce the frequency of complications. The presented series of clinical observations from the clinical archive of the authors’ team demonstrates the variants of angioarchitectonics of uterus.

About the authors

Elena Yu. Antropova

Kazan State Medical Academy — Branch of Russian Medical Academy of Continuing Professional Education

Email: antropoval@mail.ru
ORCID iD: 0000-0002-5991-5163
SPIN-code: 1393-8280

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, Kazan

Bulat M. Sharafutdinov

Kazan State Medical Academy — Branch of Russian Medical Academy of Continuing Professional Education;
Medical Unit of Kazan (Volga region) Federal University

Author for correspondence.
Email: bulaty555@mail.ru
ORCID iD: 0000-0002-4149-118X
SPIN-code: 6282-4554

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, Kazan; Kazan

Sergey A. Ryzhkin

Russian Medical Academy of Continuing Professional Education; Kazan State Medical University; Kazan (Volga region) Federal University; Federal Center of Toxicological, Radiation and Biological Safety

Email: rsa777@inbox.ru
ORCID iD: 0000-0003-2595-353X
SPIN-code: 5955-5712

MD, Dr. Sci. (Med.), Associate Professor, academician

Russian Federation, Moscow; Kazan; Kazan; Kazan

Madina I. Mazitova

Kazan State Medical Academy — Branch of Russian Medical Academy of Continuing Professional Education

Email: madina13@list.ru
ORCID iD: 0000-0002-9608-2076
SPIN-code: 7653-6594

MD, Dr. Sci. (Med.), Professor

Russian Federation, Kazan

Magomed N. Nasrullayev

Kazan State Medical Academy — Branch of Russian Medical Academy of Continuing Professional Education

Email: msh.avia@yandex.ru
ORCID iD: 0000-0001-6176-9372
SPIN-code: 8870-5329

MD, Dr. Sci. (Med.), Professor

Russian Federation, Kazan

References

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Supplementary files

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2. Fig. 1. A selective angiogram of the left uterine artery of a female patient G., 51 years old.

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3. Fig. 2. A selective angiogram of the left uterine artery of a female patient Z., 40 years, after embolization with preservation of the isthmic and vaginal branches.

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4. Fig. 3. A selective angiogram of the left uterine artery after embolization of the uterine arteries: uterine-ovarian anastomosis.

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5. Fig. 4. A selective angiogram of the left uterine artery: perifibroid blood flow — intramural location of the nodule.

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6. Fig. 5. A selective angiogram of the left uterine artery: submucous location of the nodule.

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7. Fig. 6. A selective angiogram of the left ovarian artery supplying an interstitial-subserous uterine leiomyoma (an additional source of blood supply to uterine leiomyoma).

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8. Fig. 7. A selective angiogram of the ovarian artery: utero-ovarian anastomosis type 1.

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9. Fig. 8. A selective angiogram of the ovarian artery: utero-ovarian anastomosis type 2.

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10. Fig. 9. A selective ovarian artery angiogram: blood supply to myoma through the left ovarian artery.

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