Digital uterine artery embolization and imaging procedure

The article is professionally consulted by Master, Doctor Nguyen Van Phan - Head of Interventional Imaging Unit - Department of Diagnostic Imaging and Nuclear Medicine - Vinmec Times City International General Hospital. Doctor Nguyen Van Phan is an interventional radiologist and radiologist.

Digital uterine artery angiography and embolization is a treatment that preserves uterine integrity. This technique uses X-rays and a water-soluble iodinated contrast agent to visualize the uterine arteries.

Digital angiography with background erasure is a combination of conventional angiography techniques by Seldinger technique with image processing techniques by digitizing background erasing factor.
Uterine artery embolization is an effective method of preserving uterine integrity. Safe procedure, short hospital stay, patients recover soon after the procedure. This procedure is used to treat uterine leiomyoma, endometrioma, postpartum bleeding, uterine vascular malformation....
1.1 Indications Uterine artery angiography and embolization Background digitization is indicated in cases such as:
Uterine smooth muscle tumor causes clinical signs (abdominal pain, menstrual disorders, compression, abortion....). Endometriosis in the myometrium, postpartum bleeding, uterine vascular malformation... Hemostasis: Cervical cancer, uterine bleeding, uterine artery chemotherapy.... Menorrhagia, heavy bleeding due to other causes (cervical cancer, endometriosis....) failed internal treatment. 1.2 Contraindications Like the general contraindications of angiography, angiography and digital uterine artery embolization are contraindicated in the following cases:
Existing infectious disease; liver failure, kidney failure, severe heart failure; have hemophilia; diabetes ; a history of allergy to preparations containing iodine; have a history of bronchial asthma ... Women who are pregnant, have appendicitis and are suspected of malignancy of the uterus and cervix.

2.1 Preparation of Executor Interventional Radiology Specialist Interventional Radiology Technician Anesthesiologist/technician (if patient is difficult to cooperate); Nursing. Means Digital Eraser Angiography (DSA); Image storage system, film printer, film; Specialized contrast injection machine; The lead skirt, shirt and collar help shield X-rays. Medicines Antiseptic solution for skin and mucous membranes. Local anesthetics General anesthetics (if necessary) Water-soluble iodinated contrast agents; Heparin and Heparin neutralizing drugs; General medical supplies 1, 3, 5, 10ml syringes and syringes for contrast injection machines. Physiological saline; Etroley car. Surgical clothing; Sterile kit (scissors, knife, tongs, tool tray, etc.); Cotton gauze, surgical medical adhesive tape. Special medical supplies Arterial needles; Standard conductor 0.035 inch; Circuit opening set 5F - 6F; Microcatheter 1.9F – 2.7F, microwire 0.014 - 0.018 inch; Angiography Catheter 4F - 5F Y-wire Set Embolization Materials Bio-foam to help stop bleeding; Synthetic resin (PVA); Bio-adhesive (Histoacryl); Metal coils (coils) of all sizes. Patients Patients are carefully explained about the procedure to coordinate with the doctor. Need to fast, drink before 6 hours. Can drink no more than 50ml of water. In the intervention room: the patient lies on his back, fitted with a monitor to monitor breathing, pulse, blood pressure, electrocardiogram, SpO2. Disinfect the skin, then cover with a sterile, perforated cloth. The patient is too excited, cannot lie still, needs sedation... Test card Inpatient medical record There is an approved order to perform the procedure. X-ray, micro-tomography Computed tomography (CT), magnetic resonance imaging (CHT) (if any).

2.2 Procedures Procedure This technique is done when the patient is admitted to the hospital, the patient only needs to stay at the hospital after 1-2 days after the procedure. The patient was admitted to the hospital the day before the procedure and was thoroughly explained about the procedure for peace of mind. Before the procedure, the patient needs to be catheterized and defecated. Nursing the patient on the table, placing an intravenous line, placing an electrocardiogram and a vital function monitor, covering the large antiseptic genitals in the groin area on both sides. The doctor and the assistant wear lead coats, lead collars, wash hands, and wear gloves. Spread sterile gauze on the patient. Anesthetize the area of ​​the common femoral artery 1cm below the inguinal fold. Skin incision, arterial puncture with a needle. Insert the lead and insert the arterial accessor into the femoral artery. Insert the catheter into the uterine artery and take a scan. When it is satisfactory, pump PVA mixed with contrast material until the tumor is completely blocked, then stop. Take a re-check. Next, thread into the contralateral uterine artery and follow the same steps as above. Remove catheter, femoral artery opener, and apply pressure to the puncture site. The patient lies motionless for about 6-8 hours, after which the compression bandage can be removed. After embolization, antibiotics should be given to the patient to avoid infection. Monitoring During the procedure: monitor pulse, blood pressure, After the procedure: Monitor pulse, blood pressure, intelligence, pain level and give painkillers. Check
Ultrasound after 3 - 6 - 12 - 24 months Magnetic resonance imaging can be done after 6 months.

Very few serious adverse events occur. However, some rare cases may occur such as: Bleeding, hematoma at the puncture site, but very rarely. The patient may have pain in the lower abdomen after a few hours of the procedure due to embolism, aseptic necrosis of the tumor. Treat with the use of specialist pain relievers. If you experience any unusual symptoms or complications, you should immediately contact your doctor for timely treatment. Vinmec International General Hospital is a high-quality medical facility in Vietnam with a team of highly qualified medical professionals, well-trained, domestic and foreign, and experienced.
A system of modern and advanced medical equipment, possessing many of the best machines in the world, helping to detect many difficult and dangerous diseases in a short time, supporting the diagnosis and treatment of doctors the most effective. The hospital space is designed according to 5-star hotel standards, giving patients comfort, friendliness and peace of mind.
For detailed information, please contact the hospitals and clinics of Vinmec health system nationwide.

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