Complication Rates and Effectiveness of Uterine Artery Embolization in the Treatment of Symptomatic Leiomyomas: A Systematic Review and Meta-Analysis

Toor, Sundeep S.; Jaberi, Arash; Macdonald, D. Blair; McInnes, Matthew D. F.; Schweitzer, Mark E.; Rasuli, Pasteur

doi:10.2214/ajr.11.8362

Cited by 91 publications

(69 citation statements)

References 88 publications

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“…Complications were very rare with no detectable post-procedural acute major complications which parallel meta-analysis of Toor et al (4) . We had four minor complications; two with fever, local hematoma which were managed by antibiotics, efficient compression; two presented with intolerable pain that necessities overnight admission with potent analgesics.…”

Section: Discussionsupporting

confidence: 63%

“…Heavy menstrual bleeding is controlled in 85-95% of patients while 70-90% of patients document improved pressure -related manifestations. In a recent meta-analysis by Toor et al (4) rates of symptomatic improvement for less than 1 year follow up were 87.5 (84.7-90.0) for heavy menstrual bleeding, 86.6 (82.2-90.5) for pressure-related symptoms, 77.5 (73.8-80.9) for pelvic pain. Our results for menorrhagia, bulk related symptoms are in agreement with those, 92 % of patients reporting improved menstrual bleeding and 85% of patients with pelvic pressure and other bulk-related symptoms improved at 3 months follow up post-procedural.…”

Section: Discussionmentioning

confidence: 97%

“…Patient's desire to preserve their uterus has prompted the development of uterus sparing alternatives as laparoscopic, hysteroscopic myomectomies (3) . Presence of multiple fibroids with variable sizes, locations, adding to associated pain, high post-operative morbidity as well as symptoms recurrence (25% of patients] have made myomectomy not feasible in all circumstances (4) . Uterine artery embolization (UAE) is a minimally invasive treatment alternative for management of symptomatic myomas (5) .…”

Section: Introductionmentioning

confidence: 99%

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Measurement of Uterine Leiomyomata Volume Pre and Post Uterine Artery Embolization Aided by MRI

Aly

Abdullah²,

Botros³

2018

The Egyptian Journal of Hospital Medicine

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Background: uterine fibroid embolization (UFE) is now evolving to be the first-line treatment for symptomatic uterine leiomyomata alongside the conventional surgical treatment of hysterectomy and myomectomy. Cochrane review comprises six RCTs comparing UAE versus hysterectomy or myomectomy for management of symptomatic leiomyomata where UFE had similar short and midterm outcomes, inclusive of symptomatic relief, quality of life and patient satisfaction, while benefiting from uterine preservation, shorter hospital stay and a faster recovery before resuming ordinary life activities. These benefits are in line with the minimally invasive nature of the embolization procedures. Aim of the Work: t this study aimed to review and illustrate the role of MR imaging in the pre-and post-procedural assessment for uterine fibroid patients undergoing uterine artery embolization. Patients and Methods: the current study was carried out in Radiodiagnosis Department, Faculty of Medicine, Ain shams University and specialized private radiology centers during the period between April 2017 and December 2017. It included 30 patients that were referred from gynecology clinic with their ultrasonographic reports to Radiodiagnosis Department, body imaging unit with a view to carry-out pelvic MRI with contrast. Results: imaging follow-up via pelvic MRI with contrast was obtained in 30 patients at 3, 6 months after treatment. The mean uterine volume was reduced by 25% (standard deviation was SD 0.03763) 3 months after treatment and was further reduced by a mean of 30% (SD 0.02638) by six months after treatment. Post-procedural subtraction MRI revealed mean myoma enhancement to be 5.6 + 0.5 SI in contrast to 133.4 + 18.3 SI prior to UFE. The mean dominant fibroid volume reduced by 34 % (SD 0.09247) after 3 months, 44 % (SD 0.05994) after 6 months. A cumulative reduction in both uterine and dominant leiomyoma mean volume from baseline to 6 months post -UAE was evident with significant interval changes between 3, 6 months follow up (p 0.000) Conclusion: the MRI findings following UAE vary with the interval from embolization and success of the procedure. MRI with its multiplanar capabilities was typically employed to evaluate the uterus following UAE for fibroid infarction, size reduction, location change, persistent enhancement, fibroid recurrence, changes in adenomyosis, and unexpected complications that may require surgical intervention or identify women who would benefit from repeated UAE. Recommendations: further studies on a larger scale of patients are needed to confirm the results obtained by this work.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Measurement of Uterine Leiomyomata Volume Pre and Post Uterine Artery Embolization Aided by MRI

Aly

Abdullah²,

Botros³

2018

The Egyptian Journal of Hospital Medicine

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“…Осложнения этой категории встречается и в других публикациях. Гематома места пункции, перфорация артерий и диссекция интимы встречается от 1,6% до 3,2% [6,7,8].…”

Section: результаты и обсуждениеunclassified

“…По данным некоторых авторов [1,8] кровопотеря при миомэктомии без предварительной ЭМА составляет 500-800мл.…”

Section: результаты и обсуждениеunclassified

Endovascular occlusion of uterine arteries in the treatment of symptomatic uterine leiomyoma

Abishev

Raushan

Dulat³

2017

J CLIN MED KAZ

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Objective:assess the condition of the uterus and myomatous nodes after EMA in different periods by ultrasound and MRI.Methods. EMA was performed in 632 patients with various forms of uterine fibroids. To achieve this goal, 120 observations with various forms of uterine fibroids were analyzed.Results. Reduction of myomatous nodes according to ultrasound and MRI in 1 month was -18.4-17.3%, after 3 months -40.7-42.9%, after 6 months it was -60.4-61.8% and through 12 months -72.5-74.7% (р˂0.05) respectively. Necrotic isolation of the node, expulsion of myomatous nodes and removal of the partially submucous node giving birth was observed in n-18 (15%) cases. In n-12 (10%) observations, after uterine artery embolization, laparoscopic myomectomy of the subserousmyomatous nodes was performed.Conclusion. our experience shows that EMA is highly effective method for treating uterine fibroids, performed depending on various forms alone or in combination with operational accommodation.Keywords:Embolization of uterine arteries -X-ray endovascular occlusion magnetic resonance imaging-myoma of the uterine myomatous nodes. Мақсаты: УМЗ кейін әртүрлі кезеңдерде жатыр мен миоматозды түйіндердің жағдайын УДЗ мен МРТ арқылы бағалау. Зерттеудің әдістері: EMA әртүрлі жатыр миомасы бар 632 науқаста орындалды. Осы мақсатқа жету үшін ана миомасының түрлі нысан-дары бар 120 байқау талданды. Endovascular occlusion of uterine arteries in the treatment of symptomatic uterine leiomyomaНәтижелері: Миоматозды түйіндерді ультрадыбыстық және ЕРТ бойынша 1 ай ішінде азайту -18,4-17,3%, 3 айдан кейін -40,7-42,9%, 6 айдан кейін -60,4-61,8% 12 ай -тиісінше 72,5-74,7% (р00,05).N-18 (15%) жағдайында түйінді тітіркендіргіш оқшаулау, миоматозды түйіндерді алып тастау және ішінара субмукозды түйінді босату. В-12 (10%) байқауында жатырдың артерия эмболизациясынан кейін миоматозды тораптардың лапароскопиялық миомектомиясы орындал-ды.Қорытынды: біздің тәжірибеміз көрсеткендей, EMA -әртүрлі нысандарға немесе операциялық тұрғыдан үйлесімге байланысты орын-далатын, жатыр миомасын емдеуде органды сақтаушы, жоғары тиімді әдіс.Маңызды сөздер: Жатыр артерияларының эмболизациясы -рентгендік эндоваскулярлы окклюзия-магнитті резонансты бейнелеу -миоматозды түйіндердің миомасы.

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EP29.12: Uncommon complication of uterine artery embolisation: expulsion of infarcted myoma and uterine sepsis

J¹,

Crespo²,

Ganesh³

et al. 2016

Ultrasound in Obstet & Gyne

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Complication Rates and Effectiveness of Uterine Artery Embolization in the Treatment of Symptomatic Leiomyomas: A Systematic Review and Meta-Analysis

Abstract: Symptomatic uterine leiomyoma treatment by UAE is an effective procedure with a low rate of major complications supporting its use as an alternative to hysterectomy.

Cited by 91 publications

References 88 publications

Measurement of Uterine Leiomyomata Volume Pre and Post Uterine Artery Embolization Aided by MRI

Measurement of Uterine Leiomyomata Volume Pre and Post Uterine Artery Embolization Aided by MRI

Endovascular occlusion of uterine arteries in the treatment of symptomatic uterine leiomyoma

EP29.12: Uncommon complication of uterine artery embolisation: expulsion of infarcted myoma and uterine sepsis

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