*2.1.6 Complications of UAE*

*Endometriosis*

preoperative thrombosis.

*2.1.3.5 Imaging evaluation*

*2.1.4 Operating process of UAE*

*2.1.4.1 Selection of embolic agent*

*2.1.4.2 Degree of embolism*

as the main preoperative evaluation method.

The reason is that the serum CA125 antigen of patients with this disease is secreted by ectopic endometrium between muscles, and CA125 molecules on the surface of endometrial cells are released into the blood circulation, which increases the concentration of CA125 antigen in the blood. Several studies [10] also show that serum CA125 assay is of great assistance to the diagnosis of uterine adenomyosis. Blood CA125 levels were measured for follow-up. Venous color Doppler ultrasonography of both lower limbs is particularly important to assess the presence or absence of

MRI examination, ultrasonography, CT, and other assessments, which perform the planning of the surgical approach and reduce the blindness of the procedure, can improve the success rate of surgery. By contrast, most studies recommend MRI

The patient was placed in supine position. Routine disinfection and draping were performed. After local anesthesia, the right femoral artery was punctured by Seldinger method. The catheter sheath was placed. A 5F Cobra catheter was inserted into the opening of bilateral uterine arteries for DSA. The dosage of contrast medium on each side was 6 ml and the flow rate was 2 ml/s. The uterus was significantly enlarged, the uterine artery was significantly thickened and tortuous, and the staining in the uterus was thickened. If there was uterine fibroids, the angiography showed the presence of "holding ball" abnormal vascular mass. The 3F microcatheter was used to superselect to the distal end of the main uterine artery, avoiding the ovarian artery. The uterine artery was embolized with embolic agent. The DSA was reexamined. The abnormal staining of the uterus disappeared,

and the main uterine artery was retained. The operation could be ended.

embolization is inversely proportional to the embolic agent particle size.

Embolization is divided into two types: complete embolization and incomplete embolization. Patients with uterine adenomyosis require complete embolization of the inner vascular network of the uterus, and in DSA, imaging findings show complete disappearance of focal staining, visualization of the main trunk of the uterine artery, retention of contrast agent, and no clearance of contrast agent in five cardiac cycles.

There are many embolization agents available for UAE. Generally, particle embolization agents are selected. Generally, they can be divided into absorbable and non-absorbable. Absorbable embolization agents are represented by gelatin sponge particles, and non-absorbable embolization agents are represented by polyvinyl alcohol embolization microspheres (embosphere). However, the commonly used embolic agents of other organs, such as steel ring, absolute ethanol, and super-liquid iodized oil, are not recommended for use in UAE. For the selection of embolic agent particle size, "sandwich embolization" should be used for embolization of uterine adenomyosis due to the small inner vascular network. First, particles with a diameter of 100–300 μm are selected for embolization of the inner vascular network, particles with a diameter of 300–500 μm are used for embolization of the outer vascular network, and finally particles with a diameter of 500–700 μm are used for trunk embolization [11]. The effect of arterial

**108**
