Predictors of hysterectomy after uterine artery embolization for leiomyoma

Literature review of outcomes and prevalence and case report of leiomyosarcomas and non-typical uterine smooth muscle leiomyoma tumors treated with uterine artery embolization

“…The American Fibroid study reported only one case of LMS [25]. Two cases of LMS were noted in the HOPEFUL-study [26], and the study by Gabriel-Cox reported one LMS, one adenosarcoma and one case of intravenous leiomyomatosis [27]. In total, 5 additional cases of LMS were identified, and one of these cases was observed more than two years after the use of UAE.…”

Postembolization Problems and Management

“…A higher risk for subsequent hysterectomy after UAE may exist for patients who cannot receive bilateral embolization. Hysterectomy after unilateral UAE is 2.19 times more likely than after bilateral UAE (Gabriel-Cox et al 2007). …”

Uterine Artery Embolization and New Ablation Techniques

“…Finally, larger fi broids and more numerous fi broids predict higher symptom recurrence and higher failure rates [ 12 , 13 ]. During the procedure only a unilateral UAE predicts failure, defi ned as secondary hysterectomy [ 14 ]. Directly after the procedure the following factors were of predictive value: when less than 90 % of the fi broids showed signs of infarction on the post-UAE MRI scan there was more chance of re-interventions [ 15 , 16 ].…”