Intraprocedural complications of uterine fibroid embolisation and their impact on long-term clinical outcome.

OBJECTIVES

Authors evaluate the impact of intraprocedural complications on successful technical realisation and long-term clinical outcome of the uterine fibroid embolisation.

BACKGROUND

The uterine artery embolisation (UAE) has become an accepted treatment method for uterine fibroids. In general, the unilateral embolisation is considered to be insufficient due to poor clinical effect.

METHODS

Overall, 165 uterine artery embolisations were analysed (retrospectively-prospectively) in 163 female patients. Intraprocedural complications and their impact on the possibility to perform bilateral embolisationwere evaluated. In patients with unscheduled unilateral embolisation, short-term as well as long-term clinical effects were observed with mean follow-up period of 41 months.

RESULTS

The bilateral uterine artery embolisation was possible in 95.7 % (95 %, CI 91.3-99.4 %) procedures. The unilateral embolisation was reported in 7 procedures (4.3 %, CI 1.2-8.3 %) and reasons were following: resistant arterial spasm in 4 patients (2.5 %, CI 0.7 %-5.3 %) and impossible catheterisation due to unfavourable anatomic situation in 3 patients (1.8 %, CI 0.3-4.1 %). Other complications, such as dissection and perforation, did not affect the successful technical realisation. The long-term clinical effect of unscheduled unilateral embolisation was reported in 5 patients.

CONCLUSION

The results of our series of unscheduled unilateral uterine fibroid embolisation had high long-term clinical success rate. In way of unscheduled unilateral embolisation, we recommend MRI follow-up and reintervention only in way of persistence or recurrence of symptoms with concurrent MRI finding of residual fibroids(Tab. 5, Fig. 3, Ref. 12).