Outcome in patients undergoing unilateral uterine artery embolization for symptomatic fibroids

Nicholson, Tony

doi:10.1016/j.crad.2003.08.005

Cited by 12 publications

(5 citation statements)

References 22 publications

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“…In addition to this, Gabriel-Cox et al who evaluated the medical records of 560 patients, 33 of whom had unilateral UAE, identified unilateral UAE as a single risk factor for subsequent hysterectomy [12]. This is why unilateral embolization was considered to be a non-elective, conservative treatment option for cases where technical failure in vessel catheterization occurred, for patients after unilateral uterine artery ligation or, finally, for patients with one-sided anatomical absence of uterine artery [7,8].…”

Section: Discussionmentioning

confidence: 99%

“…Although classical endovascular intervention includes the occlusion of both uterine arteries, reports on successful unilateral embolization and its potential advantages (decrease in myometrial ischemia, lower risk of non-target embolization of the ovarian blood supply and lower radiation dose) are available [6][7][8][9][10]. The initial reports described small groups of patients and observed a relatively high rate of clinical failure [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…The initial reports described small groups of patients and observed a relatively high rate of clinical failure [6,7]. Nonetheless, more recent papers reported more encouraging results and concluded that, in appropriately selected patients, unilateral embolization may have comparable clinical results to standard bilateral UAE [8,9]. In addition to that, Stall et al who compared unilateral and bilateral UAE observed that unilateral UAE is associated with significantly shorter fluoroscopy time and lower analgesia requirements due to periprocedural pain than bilateral UAE [9].…”

Section: Introductionmentioning

confidence: 99%

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Unilateral Uterine Artery Embolization as a Treatment for Patients with Symptomatic Fibroids—Experience in a Case Series

Pyra

Szmygin

et al. 2022

Medicina

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Background and Objectives: Uterine artery embolization (UAE) has become an accepted and widely performed therapy for patients with symptomatic (reporting at least two of the following symptoms: severe or prolonged menstrual bleeding, abdominal pain, tension in abdomen, problems with urination, constipation or anemia) uterine fibroids. Although in the majority of cases, bilateral occlusion is required to obtain a successful clinical outcome, there are patients in whom treatment of only one uterine artery could be attempted. There are several reasons for unilateral UAE: hemodynamic conditions, technical difficulties, anatomical variants and unilateral dominancy of blood supply to the fibroid. Our aim is to present our 10-year experience with unilateral UAE and evaluate the radiological and clinical outcomes. Materials and Methods: Records of 369 patients with fibroids who underwent UAE from 2010 to 2021 were analyzed. We identified 26 patients treated with unilateral uterine artery embolization and analyzed the data of these patients. All patients attended medical consultation, were assessed using a five-grade symptom scale and underwent MRI examination. Clinical response was evaluated at least 6 months after the procedure and was categorized to one of the following groups: complete improvement, partial improvement, no change and a worsening in symptoms. Results: Twenty-two patients (85%) reported at least partial improvement 6 months following the procedure. One patient required secondary embolization due to recanalization. The secondary procedure was successful, and complete improvement was achieved. One patient did not observe any clinical improvement, and in two cases, symptom recurrence was observed. All three patients were referred for surgical treatment. No major complications were noted. Overall, the success rate was 88%. Conclusions: The results of our study support the statement that elective unilateral embolization is an appropriate treatment in patients with a dominant uterine artery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Unilateral Uterine Artery Embolization as a Treatment for Patients with Symptomatic Fibroids—Experience in a Case Series

Pyra

Szmygin

et al. 2022

Medicina

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“…Both uterine arteries should be selectively embolized to achieve maximal efficacy. Although there have been reports describing symptomatic benefit out to 4 years when embolization was limited to a single artery for various reasons, 14 larger studies have clearly shown an increased clinical failure rate when bilateral embolization cannot be performed. 15…”

Section: Methodsmentioning

confidence: 99%

Uterine Artery Embolization: A Safe and Effective, Minimally Invasive, Uterine-Sparing Treatment Option for Symptomatic Fibroids

Andrews

2008

Semin intervent Radiol

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Leiomyomas (or fibroids) are exceedingly common lesions. The indications to initiate treatment are based on the symptoms that can arise from their presence. In general, medical therapy should be considered the first line of treatment. Currently, the treatment of fibroids is in evolution. Since uterine artery embolization (UAE) was first described by Ravina et al in 1995, it has been shown to be a safe, efficacious, and cost-effective alternative to traditional surgical options, with data from long-term studies now available. Appropriate patient evaluation and selection are vital; the ideal candidate is one who is premenopausal, has symptomatic fibroids resistant to medical therapy, no longer desires fertility, and wishes to maintain her uterus. Uterine artery embolization is primarily an angiographic procedure, but periprocedural clinical management is critical for patient satisfaction. This article discusses the various embolic materials that are commonly used and available for UAE; understanding the technical nuances is critical for long-term success.

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“…Bilateral UAE is not possible in 2.1% of patients because of anatomical variations and/or arterial spasms unresponsive to nitroglycerine or other vasodilators (Lund et al). Although there have been reports of clinical success and symptom resolution after unilateral UAE (Nicholson, 2004), the procedure is still generally considered a technical failure if bilateral UAE is not performed. UAE can usually be done in 30–45 min (Hutchins & Worthington‐Kirsch), but it may take up to 2 h (Lund et al).…”

Section: Literature Reviewmentioning

confidence: 99%

Uterine artery embolization as a treatment for symptomatic uterine fibroids: A review of literature and case report

Seals

Jones

Wolfe

2006

Journal of the American Academy of Nurse Practitioners

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Outcome in patients undergoing unilateral uterine artery embolization for symptomatic fibroids

Cited by 12 publications

References 22 publications

Unilateral Uterine Artery Embolization as a Treatment for Patients with Symptomatic Fibroids—Experience in a Case Series

Unilateral Uterine Artery Embolization as a Treatment for Patients with Symptomatic Fibroids—Experience in a Case Series

Uterine Artery Embolization: A Safe and Effective, Minimally Invasive, Uterine-Sparing Treatment Option for Symptomatic Fibroids

Uterine artery embolization as a treatment for symptomatic uterine fibroids: A review of literature and case report

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