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James B Spies - One of the best experts on this subject based on the ideXlab platform.
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menopause and menopausal symptoms after Ovarian Artery embolization a comparison with uterine Artery embolization controls
Journal of Vascular and Interventional Radiology, 2011Co-Authors: Danielle Kaw, Michael Mccullough, Hala Nsoulimaktabi, James B SpiesAbstract:Abstract Purpose To determine the impact on menstrual status and menopausal symptoms of Ovarian Artery embolization (OAE) to supplement uterine embolization (UAE) for uterine leiomyomas. Materials and Methods A single-center case-control study was conducted in women who underwent UAE for leiomyomas. Between May 2004 and July 2009, 77 patients underwent unilateral or bilateral OAE during UAE procedures. Contemporaneous control subjects undergoing UAE alone were identified based on age and race. Questionnaires queried menstrual cycle regularity, onset of menopause, hormone use, and subsequent leiomyoma interventions, as well as the Menopause Rating Scale (MRS), a validated menopausal symptom questionnaire. Records were reviewed for baseline clinical and procedure data. Case and control subjects were compared for baseline characteristics and outcomes with the use of appropriate statistics, with the primary outcome the summary score on the MRS. Results Of 154 patients, 51 case subjects and 49 control subjects responded to the MRS (65%). Case subjects had greater tumor volumes (median, 129.3 cm 3 vs 69.3 cm 3 in control subjects; P = .0252) and longer fluoroscopy times (mean, 20.5 min vs 14 min in control subjects; P P = .023), indicating fewer menopausal symptoms and no difference in menstrual regularity or frequency of onset of menopause. Of six patients who underwent bilateral OAE and responded, all reported continued menstrual cycles. Conclusions Compared with standard UAE, the addition of OAE does not appear to precipitate the onset of menopause nor increase menopausal symptom severity.
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uterine fibroid embolization the utility of aortography in detecting Ovarian Artery collateral supply
Radiology, 2007Co-Authors: Amy White, Filip Banovac, Shadi Yousefi, Rebecca Slack, James B SpiesAbstract:Purpose: To retrospectively determine the sensitivity of Ovarian Artery (OA) visualization at aortography performed after uterine fibroid embolization (UFE) and, using OA arteriography as the reference standard, compare the extent of arterial flow to the uterus at aortography with selective Ovarian arteriography, to establish the utility of aortography and Ovarian arteriography in the routine practice of UFE. Materials and Methods: This study received institutional review board approval with waiver of informed consent and was HIPAA compliant. Retrospective review of 1129 consecutive UFE patients (1072 with aortograms, 57 excluded; mean age, 44 years; range, 21–60 years) was performed to identify all visible OAs. Visible OAs were independently graded by two interventional radiologists according to extent of pelvic arterial flow. If selective arteriography was performed, a second grade was assigned based on assessment of the selective study. Descriptive and summary statistics were used for assessment by the...
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uterine fibroid embolization the utility of aortography in detecting Ovarian Artery collateral supply
Radiology, 2007Co-Authors: Amy M. White, Filip Banovac, Shadi Yousefi, Rebecca Slack, James B SpiesAbstract:PURPOSE: To retrospectively determine the sensitivity of Ovarian Artery (OA) visualization at aortography performed after uterine fibroid embolization (UFE) and, using OA arteriography as the reference standard, compare the extent of arterial flow to the uterus at aortography with selective Ovarian arteriography, to establish the utility of aortography and Ovarian arteriography in the routine practice of UFE. MATERIALS AND METHODS: This study received institutional review board approval with waiver of informed consent and was HIPAA compliant. Retrospective review of 1129 consecutive UFE patients (1072 with aortograms, 57 excluded; mean age, 44 years; range, 21-60 years) was performed to identify all visible OAs. Visible OAs were independently graded by two interventional radiologists according to extent of pelvic arterial flow. If selective arteriography was performed, a second grade was assigned based on assessment of the selective study. Descriptive and summary statistics were used for assessment by the senior observer, and interobserver variability was determined. RESULTS: Of 1072 UFE patients, 184 (17.2%) had at least one visible OA. Ten (0.8%) patients were identified at aortography with collateral OA supply to more than 10% of the uterus. In total, 251 OAs were visualized, and 157 of these were further evaluated with selective study. Sixty-two (5.8%) patients were identified at selective arteriography as having collateral OA supply. The sensitivity of aortography was approximately 18%. Interobserver concordance was high (kappa values of 0.81 and 0.90 for aortography and selective study, respectively), but not perfect. CONCLUSION: Aortography rarely helps identify patients with substantial residual OA supply to the uterus and is a poor predictor of the extent of that supply, and thus may be of limited utility in routine UFE.
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Uterine fibroid embolization: the utility of aortography in detecting Ovarian Artery collateral supply.
Radiology, 2007Co-Authors: Amy M. White, Filip Banovac, Shadi Yousefi, Rebecca Slack, James B SpiesAbstract:To retrospectively determine the sensitivity of Ovarian Artery (OA) visualization at aortography performed after uterine fibroid embolization (UFE) and, using OA arteriography as the reference standard, compare the extent of arterial flow to the uterus at aortography with selective Ovarian arteriography, to establish the utility of aortography and Ovarian arteriography in the routine practice of UFE. This study received institutional review board approval with waiver of informed consent and was HIPAA compliant. Retrospective review of 1129 consecutive UFE patients (1072 with aortograms, 57 excluded; mean age, 44 years; range, 21-60 years) was performed to identify all visible OAs. Visible OAs were independently graded by two interventional radiologists according to extent of pelvic arterial flow. If selective arteriography was performed, a second grade was assigned based on assessment of the selective study. Descriptive and summary statistics were used for assessment by the senior observer, and interobserver variability was determined. Of 1072 UFE patients, 184 (17.2%) had at least one visible OA. Ten (0.8%) patients were identified at aortography with collateral OA supply to more than 10% of the uterus. In total, 251 OAs were visualized, and 157 of these were further evaluated with selective study. Sixty-two (5.8%) patients were identified at selective arteriography as having collateral OA supply. The sensitivity of aortography was approximately 18%. Interobserver concordance was high (kappa values of 0.81 and 0.90 for aortography and selective study, respectively), but not perfect. Aortography rarely helps identify patients with substantial residual OA supply to the uterus and is a poor predictor of the extent of that supply, and thus may be of limited utility in routine UFE. (c) RSNA, 2007.
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Ovarian Artery embolization supplementing uterine embolization for leiomyomata.
Journal of Vascular and Interventional Radiology, 2003Co-Authors: Mara Barth, James B SpiesAbstract:Uterine Artery embolization for leiomyomata may fail due to additional blood supply from the Ovarian arteries. The potential role of supplemental Ovarian Artery embolization is unknown. The authors present here the results for their first six patients who were treated with Ovarian Artery embolization.
Michael D Dake - One of the best experts on this subject based on the ideXlab platform.
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angiographic classification of Ovarian Artery to uterine Artery anastomoses initial observations in uterine fibroid embolization
Radiology, 2002Co-Authors: Mahmood K Razavi, Gloria L Hwang, Kristen A Wolanske, Michael D DakeAbstract:PURPOSE: To prospectively study and classify the anastomoses between the Ovarian and uterine arteries in women undergoing uterine fibroid embolization, and to compare the presence of such with procedural failures and premature menopause. MATERIALS AND METHODS: Angiographic Ovarian Artery-to-uterine Artery anastomoses were studied in 76 consecutive patients undergoing uterine fibroid embolization. Mean patient age was 44.7 years (range, 29-56 years). Clinical follow-up consisted of a standard questionnaire. Procedural failure and complications were compared with the presence of various types of Ovarian Artery-to-uterine Artery connections. RESULTS: Three types of anastomoses were identified. In type I (33 [21.7%] of 152 arteries), flow from the Ovarian Artery to the uterus was through anastomoses with the main uterine Artery. In type II (six arteries [3.9%]), the Ovarian Artery supplied the fibroids directly. In type III (10 arteries [6.6%]), the major blood supply to the ovary was from the uterine Artery. Seven patients (9%) were considered to have clinical failure, with three of the six women with type II anastomoses being in this group. Three of the five women who experienced menopause after fibroid embolization had bilateral Ovarian Artery-to-uterine Artery anastomoses that were classified as high risk. CONCLUSION: Delineation of Ovarian Artery-to-uterine Artery anastomosis is of practical relevance in avoiding nontarget Ovarian embolization, in identification of those who would be at risk of uterine Artery embolization or Ovarian failure, and in those in whom the Ovarian Artery can be embolized safely.
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Angiographic classification of Ovarian Artery-to-uterine Artery anastomoses: initial observations in uterine fibroid embolization.
Radiology, 2002Co-Authors: Mahmood K Razavi, Gloria L Hwang, Kristen A Wolanske, Daniel Y. Sze, Stephen T. Kee, Michael D DakeAbstract:PURPOSE: To prospectively study and classify the anastomoses between the Ovarian and uterine arteries in women undergoing uterine fibroid embolization, and to compare the presence of such with procedural failures and premature menopause. MATERIALS AND METHODS: Angiographic Ovarian Artery–to–uterine Artery anastomoses were studied in 76 consecutive patients undergoing uterine fibroid embolization. Mean patient age was 44.7 years (range, 29–56 years). Clinical follow-up consisted of a standard questionnaire. Procedural failure and complications were compared with the presence of various types of Ovarian Artery–to–uterine Artery connections. RESULTS: Three types of anastomoses were identified. In type I (33 [21.7%] of 152 arteries), flow from the Ovarian Artery to the uterus was through anastomoses with the main uterine Artery. In type II (six arteries [3.9%]), the Ovarian Artery supplied the fibroids directly. In type III (10 arteries [6.6%]), the major blood supply to the ovary was from the uterine Artery....
Kristen A Wolanske - One of the best experts on this subject based on the ideXlab platform.
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Reversal of flow in the Ovarian Artery during uterine Artery embolization.
Journal of vascular and interventional radiology : JVIR, 2003Co-Authors: Kristen A Wolanske, Roy L. Gordon, Robert K. Kerlan, Mark W. Wilson, Jeanne M. Laberge, Alison JacobyAbstract:Uterine Artery embolization (UAE) is gaining increasing recognition as an effective treatment alternative to hysterectomy in select patients. As interventional radiologists gain more experience in the treatment of fibroids, new interest is being directed toward arterial communications between the uterine arteries and Ovarian arteries. This case report focuses on the potentially serious complication of flow reversal up the Ovarian Artery into the aorta during UAE.
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angiographic classification of Ovarian Artery to uterine Artery anastomoses initial observations in uterine fibroid embolization
Radiology, 2002Co-Authors: Mahmood K Razavi, Gloria L Hwang, Kristen A Wolanske, Michael D DakeAbstract:PURPOSE: To prospectively study and classify the anastomoses between the Ovarian and uterine arteries in women undergoing uterine fibroid embolization, and to compare the presence of such with procedural failures and premature menopause. MATERIALS AND METHODS: Angiographic Ovarian Artery-to-uterine Artery anastomoses were studied in 76 consecutive patients undergoing uterine fibroid embolization. Mean patient age was 44.7 years (range, 29-56 years). Clinical follow-up consisted of a standard questionnaire. Procedural failure and complications were compared with the presence of various types of Ovarian Artery-to-uterine Artery connections. RESULTS: Three types of anastomoses were identified. In type I (33 [21.7%] of 152 arteries), flow from the Ovarian Artery to the uterus was through anastomoses with the main uterine Artery. In type II (six arteries [3.9%]), the Ovarian Artery supplied the fibroids directly. In type III (10 arteries [6.6%]), the major blood supply to the ovary was from the uterine Artery. Seven patients (9%) were considered to have clinical failure, with three of the six women with type II anastomoses being in this group. Three of the five women who experienced menopause after fibroid embolization had bilateral Ovarian Artery-to-uterine Artery anastomoses that were classified as high risk. CONCLUSION: Delineation of Ovarian Artery-to-uterine Artery anastomosis is of practical relevance in avoiding nontarget Ovarian embolization, in identification of those who would be at risk of uterine Artery embolization or Ovarian failure, and in those in whom the Ovarian Artery can be embolized safely.
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Angiographic classification of Ovarian Artery-to-uterine Artery anastomoses: initial observations in uterine fibroid embolization.
Radiology, 2002Co-Authors: Mahmood K Razavi, Gloria L Hwang, Kristen A Wolanske, Daniel Y. Sze, Stephen T. Kee, Michael D DakeAbstract:PURPOSE: To prospectively study and classify the anastomoses between the Ovarian and uterine arteries in women undergoing uterine fibroid embolization, and to compare the presence of such with procedural failures and premature menopause. MATERIALS AND METHODS: Angiographic Ovarian Artery–to–uterine Artery anastomoses were studied in 76 consecutive patients undergoing uterine fibroid embolization. Mean patient age was 44.7 years (range, 29–56 years). Clinical follow-up consisted of a standard questionnaire. Procedural failure and complications were compared with the presence of various types of Ovarian Artery–to–uterine Artery connections. RESULTS: Three types of anastomoses were identified. In type I (33 [21.7%] of 152 arteries), flow from the Ovarian Artery to the uterus was through anastomoses with the main uterine Artery. In type II (six arteries [3.9%]), the Ovarian Artery supplied the fibroids directly. In type III (10 arteries [6.6%]), the major blood supply to the ovary was from the uterine Artery....
Mahmood K Razavi - One of the best experts on this subject based on the ideXlab platform.
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angiographic classification of Ovarian Artery to uterine Artery anastomoses initial observations in uterine fibroid embolization
Radiology, 2002Co-Authors: Mahmood K Razavi, Gloria L Hwang, Kristen A Wolanske, Michael D DakeAbstract:PURPOSE: To prospectively study and classify the anastomoses between the Ovarian and uterine arteries in women undergoing uterine fibroid embolization, and to compare the presence of such with procedural failures and premature menopause. MATERIALS AND METHODS: Angiographic Ovarian Artery-to-uterine Artery anastomoses were studied in 76 consecutive patients undergoing uterine fibroid embolization. Mean patient age was 44.7 years (range, 29-56 years). Clinical follow-up consisted of a standard questionnaire. Procedural failure and complications were compared with the presence of various types of Ovarian Artery-to-uterine Artery connections. RESULTS: Three types of anastomoses were identified. In type I (33 [21.7%] of 152 arteries), flow from the Ovarian Artery to the uterus was through anastomoses with the main uterine Artery. In type II (six arteries [3.9%]), the Ovarian Artery supplied the fibroids directly. In type III (10 arteries [6.6%]), the major blood supply to the ovary was from the uterine Artery. Seven patients (9%) were considered to have clinical failure, with three of the six women with type II anastomoses being in this group. Three of the five women who experienced menopause after fibroid embolization had bilateral Ovarian Artery-to-uterine Artery anastomoses that were classified as high risk. CONCLUSION: Delineation of Ovarian Artery-to-uterine Artery anastomosis is of practical relevance in avoiding nontarget Ovarian embolization, in identification of those who would be at risk of uterine Artery embolization or Ovarian failure, and in those in whom the Ovarian Artery can be embolized safely.
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Angiographic classification of Ovarian Artery-to-uterine Artery anastomoses: initial observations in uterine fibroid embolization.
Radiology, 2002Co-Authors: Mahmood K Razavi, Gloria L Hwang, Kristen A Wolanske, Daniel Y. Sze, Stephen T. Kee, Michael D DakeAbstract:PURPOSE: To prospectively study and classify the anastomoses between the Ovarian and uterine arteries in women undergoing uterine fibroid embolization, and to compare the presence of such with procedural failures and premature menopause. MATERIALS AND METHODS: Angiographic Ovarian Artery–to–uterine Artery anastomoses were studied in 76 consecutive patients undergoing uterine fibroid embolization. Mean patient age was 44.7 years (range, 29–56 years). Clinical follow-up consisted of a standard questionnaire. Procedural failure and complications were compared with the presence of various types of Ovarian Artery–to–uterine Artery connections. RESULTS: Three types of anastomoses were identified. In type I (33 [21.7%] of 152 arteries), flow from the Ovarian Artery to the uterus was through anastomoses with the main uterine Artery. In type II (six arteries [3.9%]), the Ovarian Artery supplied the fibroids directly. In type III (10 arteries [6.6%]), the major blood supply to the ovary was from the uterine Artery....
Wanching Lien - One of the best experts on this subject based on the ideXlab platform.
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spontaneous rupture of an Ovarian Artery aneurysm
American Journal of Obstetrics and Gynecology, 2009Co-Authors: Mingtse Tsai, Wanching LienAbstract:Spontaneous rupture of an Ovarian Artery aneurysm is rare and is thought to be related to pregnancy or uterine fibroids. A patient without fibroids presented with extreme pain during normal menstruation. Ruptured Ovarian Artery aneurysm should be suspected in a multiparous woman with flank or abdominal pain and peritoneal signs.