From the Guidelines
After uterine artery ablation, the ovarian arteries provide the primary collateral blood supply to the uterus, with additional contributions from the vaginal arteries and internal pudendal arteries. The ovarian arteries, which originate from the abdominal aorta, form anastomoses with the uterine arteries in the mesovarium and mesosalpinx, creating an important alternative pathway for blood flow 1. This is supported by a study published in the Journal of the American College of Radiology, which highlights the importance of assessing ovarian arterial collateral supply to the uterus during treatment planning for uterine fibroids 1.
The development of this collateral circulation is a physiological adaptation that maintains tissue perfusion when the primary blood supply is compromised. The vaginal arteries, branches of the internal iliac artery, supply the lower uterine segment and cervix, while the internal pudendal arteries contribute through connections in the parametrial tissue. This extensive collateral network explains why uterine artery embolization procedures may sometimes fail to completely devascularize uterine fibroids or why the uterus remains viable despite uterine artery occlusion.
Key points to consider:
- The ovarian arteries are the primary source of collateral blood supply to the uterus after uterine artery ablation 1.
- The vaginal arteries and internal pudendal arteries also contribute to the collateral circulation 1.
- The development of collateral circulation is a gradual process that occurs after the ablation procedure, with the ovarian arterial contribution becoming more significant over time.
- Assessing ovarian arterial collateral supply is important during treatment planning for uterine fibroids, as it can impact the effectiveness of uterine artery embolization procedures 1.
From the Research
Uterine Artery Ablation and Collateral Supply
- After uterine artery ablation, the ovarian artery provides collateral supply to the uterus 2, 3, 4.
- The uterine and ovarian arteries form anastomoses, allowing for collateral blood flow to the uterus 3, 4.
- The direction of blood flow through these anastomoses can shift depending on the phase of the menstrual cycle, with the ovarian artery providing more blood flow to the uterus during the follicular phase 4.
Blood Supply to the Uterus
- The blood supply to the uterus is provided by the uterine and ovarian arteries, which form a complex network of anastomoses 3, 4.
- The ovarian artery can provide collateral blood supply to the uterus, especially in cases where the uterine artery is occluded or ablated 2, 3, 4.
- The vascular supply to the uterus is dynamic and can change in response to various physiological and pathological conditions 3, 4, 5, 6.
Clinical Implications
- Understanding the collateral blood supply to the uterus is important for the management of uterine disorders, such as uterine leiomyomata 2.
- Uterine artery ablation can be an effective treatment for uterine leiomyomata, but it may also affect ovarian function and blood flow 2, 5, 6.
- Further studies are needed to fully understand the effects of uterine artery ablation on ovarian function and blood flow, as well as the potential risks and benefits of this procedure 5, 6.