Objective To evaluate the efficacy of superselective embolization of the supplying arteries of uterine fibroids under the guidance of 3D angiography in treating uterine fibroids.Methods The clinical data of 14 patients with uterine fibroids,who received interventional embolization therapy at the Third Affiliated Hospital of Zhengzhou University of China,were retrospectively analyzed.Of the 14 patients,5 received microcatheter superselective embolization of the supplying arteries of uterine fibroids after the origin and path of the supplying arteries were clarified by 3D uterine artery angiography(group A),and 9 received embolization of the bilateral uterine arteries up to their main trunks because the fibroids had complex blood supply(group B).The sums of the preoperative and postoperative one-year maximum diameter of uterine fibroids,and the reduction rate of fibroid were statistically analyzed.Results The mean sum of the preoperative and postoperative one-year maximum diameter of uterine fibroids in group A were(85.00±43.35)mm and(35.20±25.96)mm respectively,and the difference was statistically significant(P=0.006),which in group B were(65.00±12.68)mm and(49.44±24.83)mm respectively,and the difference was not statistically significant(P=0.052).There was no statistically significant differences in the mean sum of the preoperative maximum diameter of uterine fibroids and in the postoperative one-year maximum diameter of uterine fibroids between the two groups(P=0.366 and P=0.331).The median reduction rate of uterine fibroids in group A and group B was 62％and 25％respectively,and the difference was statistically significant(P=0.031).Conclusion For the treatment of uterine fibroids,3D angiography-guided superselective embolization of the supplying arteries of uterine fibroids is superior to the embolization of the bilateral uterine arteries in clinical curative efficacy.(J Intervent Radiol,2024,33:533-536)

Objective:To explore the influencing factors of clinical pregnancy outcomes in patients with hydrosalpinx undergoing in vitro fertilization-embryo transfer(IVF-ET) after interventional embolization and whether residual hydrops has an adverse impact on pregnancy outcomes.Methods:Clinical data from 65 patients who underwent interventional embolization and IVF-ET for hydrosalpinx at the Third Affiliated Hospital of Zhengzhou University from March 2021 to October 2022 were collected retrospectively. The hydrops index was quantified by the ratio of the widest diameter to the pelvic transverse diameter of the intraoperative hydrops, and the patient′s age, body mass index(BMI), follicle-stimulating hormone(FSH), lutenizing hormine(LH), estradiol(E2), automated matetials hangling(AMH), endometrial thickness at the time of transplantation, the number of transplanted embryos, embryo type, and location of the hydrosalpinx were recorded. In addition, the clinical pregnancy outcomes of the first transplantation after embolization were followed. Two independent samples t-test, rank sum test and chi-square test were used to analyze the difference of the above indexes among different clinical pregnancy outcomes by SPSS 25.0. The receiver operating characteristic (ROC) curves and Youden index were used to calculate the cut-off value of the water accumulation index. Results:Among 65 patients, the clinical pregnancy rate was 63.1%(41/65), among the 45 patients who underwent embryo transfer before embolization without success, the clinical pregnancy rate after embolization was 62.2%(28/45). Based on data analysis, it showed that IVF-ET clinical pregnancy outcomes were not associated with age, BMI, FSH, LH, E2, AMH, endometrial thickness at the time of transplantation, the number of transplanted embryos, embryo type, as well as location of hydrosalpinx( P>0.05), but associated with hydrosalpinx index( P<0.001). ROC curve analysis showed that the hydrops index could be used as a predictor of pregnancy outcome, and the area under the curve was 0.825, and the optimal cut-off value of the hydrops index was 12.925% based on the Youden index analysis result. Conclusions:Interventional embolization of hydrosalpinx may improve clinical pregnancy rates. When the hydrosalpinx is large enough, it could adversely affected IVF-ET clinical pregnancy, and further aspiration of hydrosalpinx should be performed prior to transplantation.