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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_3932_Библиотеки_им_академика_М_И_Перельмана.pdf
xi
Disclaimer
There are many commercial products that are specifi cally listed in each of the chapters of
this book. The editors and contributors have given their personal and anecdotal description
of specifi c product use in order to be helpful. However, with only one exception (Wayne
Olan, M.D.), the editors and authors are not affi liated with or have fi nancial interest in the
products mentioned.
Further, absolutely none of the editors and authors received any fi nancial incentive to
discuss any of the specifi c products mentioned in this book.
xiii
Part I Pelvic Vascular Interventions
1 Uterine Artery Embolization ............................................................................... 3
Shawn N. Sarin, Chad Baarson, Sameul Hanif, Yousaf Awan,
and Anthony C. Venbrux
2 Pelvic Varices Embolization ................................................................................. 37
Anthony C. Venbrux, Giriraj K. Sharma, Emily Timmreck Jackson,
Amy P. Harper, and Lena Hover
Part II Fallopian Tube Interventions
3 Fallopian Tube Recanalization ............................................................................ 63
Elizabeth Ann Ignacio, Taara Sultaana Hassan, John C. Lipman,
and Farhang Adabi
4 Fallopian Tube Occlusion ..................................................................................... 83
Elizabeth Ann Ignacio, Nadia J. Khati, John C. Lipman,
and Prasanna Vasudevan
Part III Spine Interventions
5 Kyphoplasty and Vertebroplasty ......................................................................... 107
Jozef M. Brozyna, Denis Primakov, Anthony C. Venbrux,
Ajay D. Wadgaonkar, Sarah LaFond, Jay Karajgikar, and Wayne J. Olan
6 Spine Pain Management ....................................................................................... 137
Anthony C. Venbrux, Jozef M. Brozyna, Denis Primakov,
and Wayne J. Olan
Contents
xiv
Contents
Part IV Lower Extremity Venous Interventions
7 Lower Extremity Venous Ablation and Sclerotherapy ...................................... 151
Albert K. Chun, Aaron Himchak, Jason B. Katzen, Chad Baarson,
Anthony C. Venbrux, and Nadia J. Khati
Index ............................................................................................................................ 179
xv
Farhang Adabi , RTR
Department of Radiology,
Division of Interventional Radiology,
The George Washington University
Medical Center , Washington ,
DC , USA
Yousaf Awan , M.D.
Department of Radiology ,
University of Maryland Medical Center ,
Baltimore , MD , USA
Chad Baarson , DO
Department of Radiology ,
National Capitol Consortium ,
Bethesda , MD , USA
Jozef M. Brozyna , B.S., B.A.
West Virginia School of Osteopathic
Medicine , Lewisburg , WV , USA
Albert K. Chun , M.D.
Department of Radiology,
Division of Interventional Radiology ,
The George Washington University
Medical Center , Washington , DC , USA
Sameul Hanif , M.D.
The George Washington University
Medical Center , Washington , DC , USA
Amy P. Harper , MSN, ACNP-BC
Division of Radiology, Division of
Interventional Radiology ,
The George Washington University
Medical Center , Washington , DC , USA
Taara Sultaana Hassan , M.D.
The George Washington University School
of Medicine , Washington , DC , USA
Aaron Himchak , M.D.
Department of Radiology Morristown
Medical Center , Morristown , NJ , USA
Lena Hover , RTR
Department of Radiology,
Division of Interventional Radiology ,
The George Washington University
Medical Center , Washington , DC , USA
Elizabeth Ann Ignacio , M.D.
Department of Radiology, Division of
Interventional Radiology ,
The George Washington University
Medical Center , Washington , DC , USA
Emily Timmreck Jackson , MSN,
ACNP-BC
Department of Radiology,
Division of Interventional Radiology ,
The George Washington University
Medical Center , Washington , DC , USA
Jay Karajgikar , B.A.
Department of Radiology , The George
Washington University Medical Center ,
Washington , DC , USA
Jason B. Katzen , M.D.
Department of Radiology ,
The George Washington University
Medical Center , Washington , DC , USA
Contributors
xvi
Contributors
Nadia J. Khati , M.D.
Department of Radiology,
Division of Body Imaging ,
The George Washington University
Medical Center , Washington ,
DC , USA
Sarah LaFond , M.D.
The George Washington University School
of Medicine , Washington , DC , USA
John C. Lipman , M.D., FSIR
Interventional Radiology ,
Atlanta Interventional Institute,
Emory Adventist Hospital ,
Atlanta , GA , USA
Wayne J. Olan , M.D.
Department of Neurosurgery ,
Division of Interventional Radiology,
The George Washington University
Medical Center , Washington , DC , USA
Denis Primakov , M.D.
Department of Radiology ,
National Naval Medical Center ,
Bethesda , MD , USA
Shawn N. Sarin , M.D.
Department of Radiology, Division of
Interventional Radiology ,
The George Washington University
Medical Center , Washington , DC , USA
Giriraj K. Sharma , M.D., M.S.
Department of Radiology ,
The George Washington University
Medical Center , Washington , DC , USA
Prasanna Vasudevan , M.D., B.S.
Department of Radiology ,
The George Washington University
Medical Center , Washington , DC , USA
Anthony C. Venbrux , M.D.
Department of Radiology,
Division of Interventional Radiology ,
The George Washington University
Medical Center , Washington , DC , USA
Ajay D. Wadgaonkar , M.D.
The Russel H. Morgan Department of
Radiology and Radiological Science ,
The Johns Hopkins Hospital ,
Baltimore , MD , USA
P a r t I
Pelvic Vascular Interventions
3
E.A. Ignacio and A.C. Venbrux (eds.), Women’s Health in Interventional Radiology,
DOI 10.1007/978-1-4419-5876-1_1, © Springer Science+Business Media, LLC 2012
Introduction
Uterine artery embolization has become a signifi cant interventional procedure that is
performed electively to treat symptoms related to symptomatic uterine leiomyoma. This
chapter will deal with elective workup and management of uterine leiomyoma.
The traditional treatment for symptomatic leiomyomata has primarily consisted of sur-
gery, either hysterectomy or myomectomy (surgical removal of leiomyomata without hys-
terectomy). Hysterectomy has been considered the defi nitive treatment for leiomyomata
because there is no chance of post-procedure recurrence. However, there are disadvantages
of hysterectomy, including an estimated overall complication rate of 17–23% regardless of
approach (abdominal, transvaginal, or laparoscopic) [ 1 ] . Hysterectomy is not appropriate
for women who wish to preserve fertility. Myomectomy allows for women to retain their
uterus, but there is a chance that an emergent hysterectomy may need to be performed due
to excessive intraoperative bleeding. Also, symptoms due to uterine fi broids often recur in
patients who have undergone myomectomy due to continued growth of remaining leio-
myomata. In one study, the cumulative incidence of a repeat surgery due to fi broid recur-
rence was 23.5% at 5 years and 30% at 7 years [ 2 ] . Therefore, despite the fact that
myomectomy allows for uterine retention, there is a signifi cant risk of the need for
additional surgery.
Uterine Artery Embolization (UAE) is a less invasive alternative to treating symptom-
atic uterine fi broids that preserves the uterus. In 1997, UAE was utilized in the United
States for the fi rst time in treating symptomatic uterine fi broids. This technique was
described by Goodwin et al. [ 3 ] . UAE requires transcatheter embolization of the uterine
arteries and devascularizes the leiomyomata. This is accomplished by delivering particulate
emboli, such as polyvinyl alcohol particles or microspheres, into both uterine arteries. This
markedly decreases blood fl ow at the arteriolar level. As a result, an irreversible ischemic
injury to the fi broid is produced while preserving uterine function in the majority of cases.
S.N. Sarin (*)
Department of Radiology, Division of Interventional Radiology ,
The George Washington University Medical Center , Washington , DC , USA
e-mail: ssarin@gwu.edu
Uterine Artery Embolization
Shawn N. Sarin , Chad Baarson , Sameul Hanif ,
Yousaf Awan , and Anthony C. Venbrux
1