Book contents
- Frontmatter
- Contents
- Contributors
- Preface
- Foreword
- 1 Uterine fibroids: epidemiology and an overview
- 2 Histopathology of uterine leiomyomas
- 3 Imaging of uterine leiomyomas
- 4 Abdominal myomectomy
- 5 Laparoscopic managment of uterine myoma
- 6 Hysteroscopic myomectomy
- 7 Myomas in pregnancy
- 8 Expectant and medical management of uterine fibroids
- 9 Hysterectomy for uterine fibroid
- 10 History of embolization of uterine myoma
- 11 Uterine artery embolization – vascular anatomic considerations and procedure techniques
- 12 Pain management during and after uterine artery embolization
- 13 Patient selection, indications and contraindications
- 14 Results of uterine artery embolization
- 15 Side effects and complications of embolization
- 16 Reproductive function after uterine artery embolization
- 17 Reasons and prevention of embolization failure
- 18 Future of embolization and other therapies from gynecologic perspectives
- 19 The future of fibroid embolotherapy: a radiological perspective
- Index
- Plate section
11 - Uterine artery embolization – vascular anatomic considerations and procedure techniques
Published online by Cambridge University Press: 10 November 2010
- Frontmatter
- Contents
- Contributors
- Preface
- Foreword
- 1 Uterine fibroids: epidemiology and an overview
- 2 Histopathology of uterine leiomyomas
- 3 Imaging of uterine leiomyomas
- 4 Abdominal myomectomy
- 5 Laparoscopic managment of uterine myoma
- 6 Hysteroscopic myomectomy
- 7 Myomas in pregnancy
- 8 Expectant and medical management of uterine fibroids
- 9 Hysterectomy for uterine fibroid
- 10 History of embolization of uterine myoma
- 11 Uterine artery embolization – vascular anatomic considerations and procedure techniques
- 12 Pain management during and after uterine artery embolization
- 13 Patient selection, indications and contraindications
- 14 Results of uterine artery embolization
- 15 Side effects and complications of embolization
- 16 Reproductive function after uterine artery embolization
- 17 Reasons and prevention of embolization failure
- 18 Future of embolization and other therapies from gynecologic perspectives
- 19 The future of fibroid embolotherapy: a radiological perspective
- Index
- Plate section
Summary
Anatomic considerations
Familiarity with the relevant vascular anatomy is absolutely essential before discussion of the uterine artery embolization (UAE) procedure itself. The internal iliac artery typically bifurcates into two divisions. The posterior division typically originates postero-medially and sweeps laterally out of the pelvis. The dominant vessel of the posterior division is the superior gluteal artery. When performing UAE, the posterior division and its branches must be avoided, as inadvertent embolization of these vessels can lead to severe complications such as buttock necrosis and damage to the sciatic nerve.
The anterior division originates anterolaterally and courses caudad from the internal iliac bifurcation. It has a number of important branches. The dominant vessel of the anterior division is the inferior gluteal artery. The main branches of the anterior division (in the female) are the uterine artery, the cystic artery, the vaginal artery, the rectal artery, and the internal pudendal artery.
The uterine artery is usually the first branch of the anterior division. This pattern is seen in just under half of patients. Most of the standard anatomic texts describe its origin as antero-medial. Experience has shown that the origin of the uterine artery is just as likely to be antero-lateral as antero-medial. There are two common anatomic variants for the origin of the uterine artery.
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- Chapter
- Information
- Uterine FibroidsEmbolization and other Treatments, pp. 83 - 90Publisher: Cambridge University PressPrint publication year: 2003
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