Ultrasound-guided Microwave Ablation for Uterine Arteriovenous Fistula
10.11714/jsysu.med.YX20260079
- VernacularTitle:超声引导下微波消融治疗子宫动静脉瘘探讨
- Author:
Yanxia FU
1
;
Donghan LI
1
;
Liqin CHENG
1
;
Liqin ZENG
1
Author Information
1. Department of Gynecology， The Eighth Affiliated Hospital of Sun Yat-sen University， Shenzhen 518000， China
- Publication Type:Journal Article
- Keywords:
uterine arteriovenous fistula;
uterine artery embolization;
ultrasound-guided;
contrast-enhanced ultrasound;
microwave ablation;
treatment
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2026;47(4):739-746
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo analyze the clinical manifestations， diagnostic approaches， treatment strategies， and prognostic outcomes of uterine arteriovenous fistula （UAVF）. MethodsWe retrospectively analyzed 6 patients with confirmed UAVF admitted to the Department of Gynecology， the Eighth Affiliated Hospital of Sun Yat-sen University， between January 2010 and December 2023. We summarized the clinical data of the cohort， including age， gravidity， chief complaints， treatment regimens， and postoperative follow-up outcomes， and explored the clinical efficacy and safety of ultrasound-guided microwave ablation for UAVF in conjunction with a literature review. ResultsThe patients were aged 26-44 years， with a mean age of （34.33±6.12） years and a median age of 33.5 years. All patients were initially screened via color Doppler ultrasound and definitively diagnosed by imaging modalities including uterine arteriography， computed tomography， and magnetic resonance imaging. The median gravidity was 4（4，6）， with 5 patients having a history of ≥2 pregnancies. Five patients had a history of intrauterine instrumentation， among whom 4 had undergone ≥2 procedures. Regarding clinical presentations， 3 patients presented with abnormal vaginal bleeding （2 with massive hemorrhage）， 2 were asymptomatic with abnormalities detected only on imaging， and 1 reported lower abdominal pain. In terms of management， 1 patient with recurrence after uterine artery embolization （UAE） underwent ultrasound-guided microwave ablation； 1 received UAE alone； 2 patients with concomitant retained products of conception underwent hysteroscopic mechanical morcellation （1 developed massive hemorrhage 10 hours postoperatively， which was successfully controlled with uterine balloon tamponade）； 1 underwent focal lesion resection； and 1 underwent total hysterectomy. All 6 patients achieved favorable therapeutic outcomes. ConclusionAbnormal vaginal bleeding is the most typical clinical manifestation of UAVF， and digital subtraction angiography of the uterine arteries is recognized as the gold standard for definitive diagnosis. Emergency UAE is indicated for patients presenting with acute massive hemorrhage and hemodynamic instability. For patients with failed UAE or post-UAE recurrence who desire uterine and fertility preservation， ultrasound-guided microwave ablation represents a safe， effective， and novel minimally invasive therapeutic option.
