de Wit Adeline, Tassi Marc-Florent, Herbreteau Denis, Marret Henri
Faculté de Médecine, Gynécologie-Obstétrique Chef de Clinique Des Universités-Assistante Hospitalière, Tours, France.
Pôle Santé Publique, Centre Hospitalier Universitaire de Tours, Tours, France.
BJOG. 2025 Mar;132(4):518-528. doi: 10.1111/1471-0528.18023. Epub 2024 Dec 1.
We aim to clarify potential risk factors of complications after uterine artery embolisation (UAE).
Complications after uterine artery embolisation (UAE) for symptomatic fibroids are rare, but failure of treatment occurs for approximately 13%-24% of patients at 10 years.
We conducted a case-control study including all complications post UAE over 15 years in our specialised unit.
All Grade 2 complications (or worse) for the Society of Interventional Radiology Standards of Practice Committee complications post UAE were considered. One thousand one hundred seventy-two UAE were performed.
Complications were divided into two groups: early (< 1 month) or late (≥ 1 month) to differentiate complications from failure of procedure. Multinomial analysis was conducted to assess links between complications and potential risk factors.
Sixty-nine (0.06%) complications were found: 24.6% hospitalisation for pain (n = 17/69), 30.4% for infection (n = 21/69) and 2.9% expulsion of fibroid (n = 2/69). Overall, 31 patients underwent a second procedure (45%).
Intra-uterine device and multiple fibroids were strongly related to early complications (OR = 4.44, IC 95%: 1.5-13.3 and OR = 3.7, IC 95%: 1.2-11.3, respectively). The only factor that appeared to be associated with risk of early and late complications was the major fibroid's diameter (for an increased size of 25 mm, OR = 1.7, IC 95%: 1.1-2.6; OR = 1.5, IC 95%: 1.04-2.2).
Our study enlightens about the potential risk factors of UAE's complications and differentiate their impact between early and late complications.
我们旨在阐明子宫动脉栓塞术(UAE)后并发症的潜在风险因素。
有症状子宫肌瘤的子宫动脉栓塞术(UAE)后并发症罕见,但10年时约13%-24%的患者治疗失败。
我们进行了一项病例对照研究,纳入了我们专科单位15年来UAE后的所有并发症。
考虑了介入放射学会实践标准委员会关于UAE后并发症的所有2级(或更严重)并发症。共进行了1172例UAE。
并发症分为两组:早期(<1个月)或晚期(≥1个月),以区分并发症与手术失败。进行多项分析以评估并发症与潜在风险因素之间的联系。
发现69例(0.06%)并发症:24.6%因疼痛住院(n=17/69),30.4%因感染(n=21/69),2.9%肌瘤排出(n=2/69)。总体而言,31例患者接受了二次手术(45%)。
宫内节育器和多发性肌瘤与早期并发症密切相关(分别为OR=4.44,95%CI:1.5-13.3和OR=3.7,95%CI:1.2-11.3)。唯一似乎与早期和晚期并发症风险相关的因素是主要肌瘤的直径(直径增加25mm,OR=1.7,95%CI:1.1-2.6;OR=1.5,95%CI:1.04-2.2)。
我们的研究揭示了UAE并发症的潜在风险因素,并区分了它们对早期和晚期并发症的影响。