Skip to main content

Clinical Results of Fibroid Embolisation, Trials and Registries

  • Chapter
Radiological Interventions in Obstetrics and Gynaecology

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

Uterine fibroids are the most common tumour to affect women. Many are asymptomatic but when treatment is required there is almost always a choice. Uterine artery embolisation (UAE) is a relatively new minimally invasive technique and is usually one of the options. Initially slow to be accepted it is now a recognised, approved and funded procedure in most countries. It is the duty of any doctor to discuss all treatment options available with the patient. This discussion should be based on the best evidence available and it is the duty of the doctor to remain up-to-date with that information. The discussion should be fair, balanced and non-prejudicial. After the consultation patients should feel empowered to make an informed choice. The choice is usually between surgery and UAE and this chapter attempts to inform the reader of the current evidence base.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

EBM:

Evidence-Based Medicine

HRQOL:

Health-Related Quality of Life

SF-36:

Short Form (36) Health Survey

UAE:

Uterine Artery Embolisation

UFS-QOL:

Uterine Fibroid Symptom and Quality of Life

UK:

United Kingdom

USA:

United States of America

References

  • Beinfeld MT, Bosch JL, Isaacson KB, Gazelle GS (2004) Cost-effectiveness of uterine artery embolization and hysterectomy for uterine fibroids. Radiology 230:207–213

    Article  Google Scholar 

  • British Society of Interventional Radiology (BSIR) UK fibroid registry report; http://www.bsir.org/Images/_Members/_Thomas_1303/File/uae_report_website.pdf

  • de Blok S, de Vries C, Prinssen HM, Blaauwgeers HL, Jorna- Meijer LB (2003) Fatal sepsis after uterine artery embolization with microspheres. J Vasc Interv Radiol 14:779–783

    Article  Google Scholar 

  • Edwards R, Moss J, Lumsden M et al (2007) Uterine-artery embolization versus surgery for symptomatic uterine fibroids. N Engl J Med 356:360–370

    Article  CAS  Google Scholar 

  • Femme trial. http://www.hta.ac.uk/project/2378.asp

  • Goodwin SC, Spies JB, Worthinton-Kirsch R et al (2008) Uterine artery embolization for treatment of leiomyomata, long-term outcomes from the FIBROID registry. Obstet Gynecol 111:22–33

    Article  Google Scholar 

  • Gupta JK, Sinha AS, Lumsden MA et al (2006) Uterine artery embolization for symptomatic uterine fibroids. Cochrane Database Syst Rev 1:CD005073

    Google Scholar 

  • Hamoda H, Tait P, Edmonds D (2009) Fatal pulmonary embolism after uterine artery fibroid embolisation. Cardiovasc Interv Radiol 32:1080–1082

    Article  Google Scholar 

  • Hehenkamp WJ, Volkers NA, Donderwinkel PF et al (2005) Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids (EMMY trial): peri- and post-procedural results from a randomized controlled trial. Am J Obstet Gynecol 193:1618–1629

    Article  Google Scholar 

  • Hehenkamp WJ, Volkers NA, Broekmans FJ et al (2007) Loss of ovarian reserve after uterine artery embolization: a randomized comparison with hysterectomy. Hum Reprod 22:1996–2005

    Article  CAS  Google Scholar 

  • Hehenkamp WJ, Volkers NA, Birnie E, Reekers JA, Ankum WM (2008) Symptomatic uterine fibroids: treatment with uterine artery embolization or hysterectomy: results from the randomized clinical embolisation versus hysterectomy (EMMY) trial. Radiology 246:823–832

    Article  Google Scholar 

  • Hirst A, Dutton S, Wu O, Briggs A, Edwards C,Waldenmaier L et al (2008) A multi-centre retrospective cohort study comparing the efficacy, safety and cost-effectiveness of hysterectomy and uterine artery embolisation for the treatment of symptomatic uterine fibroids. The HOPEFUL study. Health Technol Assess 12(5):1–248

    Article  CAS  Google Scholar 

  • Homer H, Saridogan E (2010) Uterine artery embolization for fibroids is associated with an increased risk of miscarriage. Fertil Steril 94:324–330

    Article  Google Scholar 

  • Lanocita R, Frigerio L, Patelli G, Di Tolla G, Spreafico C (1999) A fatal complication of percutaneous transcatheter embolization for treatment of uterine fibroids. Second International Symposium on the Embolization of Uterine Myomata, Boston

    Google Scholar 

  • Landow W. (2001) Deaths after uterine embolization. In: Spies J, Warren E, Mathias S, Walsh S, Roth A, Pentecost M. Uterine Fibroid Embolization. Personal

    Google Scholar 

  • Lefebvre G, Vilos G, Asch M (2004) Society of obstetricians and gynaecologists of Canada, Canadian Association of Radiologists, Canadian Interventional Radiology Association, uterine fibroid embolization (UFE). J Obstet Gynaecol Can 26(899–911):913–928

    Article  Google Scholar 

  • Manyonda IT, Bratby M, Horst JS (2011) Uterine artery embolization versus myomectomy: impact on quality of life—results of the FUME (fibroids of the uterus: myomectomy versus embolization) trial. Cardiovasc Intervent Radiol. doi 10.1007/s00270-011-0228-5

  • Mara M, Fucikova Z, Maskova J, Kuzel D, Haakova L (2006) Uterine fibroid embolization versus myomectomy in women wishing to preserve fertility: preliminary results of a randomized controlled trial. Eur J Obstet Gynecol Reprod Biol 126:226–233

    Article  Google Scholar 

  • Mara M, Maskova J, Fucikova Z et al (2008) Midterm clinical and first reproductive results of a randomized controlled trial comparing uterine fibroid embolization and myomectomy. Cardiovasc Intervent Radiol 31:73–85

    Article  Google Scholar 

  • Moss J, Cooper K, Khaund A, Murray L, Murray G, Wu O, Craig L, Lumsden M (2011) Randomised comparison of uterine artery embolisation (UAE) with surgical treatment in patients with symptomatic uterine fibroids (REST trial): 5-year results. BJOG 118:936–944

    Article  CAS  Google Scholar 

  • Pinto I, Chimeno P, Paul L et al (2003) Uterine fibroids: uterine artery embolization versus abdominal hysterectomy for treatment—a prospective randomized, and controlled clinical trial. Radiology 226:425–431

    Article  Google Scholar 

  • Pourrat XJ, Fourquet F, Guerif F, Viratelle N, Herbreteau D, Marret H (2003) Medico-economic approach to the management of uterine myomas: a 6-month cost-effectiveness study of pelvic embolization versus vaginal hysterectomy. Eur J Obstet Gynecol Reprod Biol 111:59–64

    Article  Google Scholar 

  • Rashid S, Khaund A, Murray L, Moss J, Cooper K, Lyons D, Murray G, Lumsden M (2010) The effects of uterine artery embolisation and surgical treatment on ovarian function in women with uterine fibroids. BJOG 117:985–989

    Article  CAS  Google Scholar 

  • Ravina JH, Herbreteau D, Ciraru-Vigneron N, Houdart E, Aymar A, Merland JJ (1995) Arterial embolization to treat uterine myomata. Lancet 346:671–672

    Article  CAS  Google Scholar 

  • Sacks D, McClenny T, Cardella J, Lewis C (2003) Society of interventional radiology clinical practice guidelines. J Vasc Interv Radiol 14:S199–S202

    Article  Google Scholar 

  • Scottish Intercollegiate Guidelines Network. http://www.sign.ac.uk/guidelines/fulltext/50/annexb.html

  • Spies JB, Coyne K, Guaou GN, Boyle D, Skyrnarz-Murphy K, Gonzalves SM et al (2002) The UFS-QOL, a new disease-specific symptom and health-related quality of life questionnaire for leiomyomata. Obstet Gynecol 99(2):290–300

    PubMed  Google Scholar 

  • Spies JB, Myers ER, Worthinton-Kirsch R et al (2005) The FIBROID registry, symptom and quality-of-life status 1 year after therapy. Obstet Gynecol 106:1309–1318

    Article  Google Scholar 

  • Tropeano G, Statsi CD, Amoroso S et al (2010) Long-term effects of uterine fibroid embolization on ovarian reserve: a prospective cohort study. Fertil Steril 94:2296–2300

    Article  Google Scholar 

  • Van der Kooij SM, Hehenkamp WJ, Volkers NA et al (2010) Uterine artery embolization vs hysterectomy in the treatment of symptomatic uterine fibroids: 5-year outcome from the randomized EMMY trial. Am J Obstet Gynecol 203:105.e1–13

    Google Scholar 

  • Van der Kooij SM, Bipat S, Hehenkamp WJK et al (2011) Uterine artery embolization versus surgery in the treatment of symptomatic fibroids: a systematic review and metaanalysis. Am J Obstet Gynecol 205:317.e1–18

    Google Scholar 

  • Vashisht A, Studd J, Carey A, Burn P (1999) Fatal septicaemia after fibroid embolisation. Lancet 354(9175):307–308

    Article  CAS  Google Scholar 

  • Volkers NA, Hehenkamp WJ, Birnie E et al (2006) Uterine artery embolization in the treatment of symptomatic uterine fibroids (EMMY trial): periprocedural results and complications. J Vasc Interv Radiol 17:471–480

    Article  Google Scholar 

  • Volkers NA, Hehenkamp WJ, Birnie E, Ankum WM, Reekers JA (2007) Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids: 2 years’ outcome from the randomized EMMY trial. Am J Obstet Gynecol 196(519):e1–e11

    Google Scholar 

  • Volkers NA, Hehenkamp WJ, Smit P et al (2008) Economic evaluation of uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids: results from the randomized EMMY trial. J Vasc Interv Radiol 19:1007–1017

    Article  Google Scholar 

  • Worthinton-Kirsch R, Spies J, Myers E et al (2005) The fibroid registry for outcomes data (FIBROID) for uterine embolization short-term outcomes. Obstet Gynecol 106:52–59

    Article  Google Scholar 

  • Wu O, Briggs A, Dutton S, Hirst A, Maresh M, Nicholson A et al (2007) Uterine artery embolisation or hysterectomy for the treatment of symptomatic uterine fibroids: a cost-utility analysis of the HOPEFUL study. BJOG 114:1352–1362

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jon. G. Moss .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer Berlin Heidelberg

About this chapter

Cite this chapter

Yadavali, R.P., Moss, J.G. (2012). Clinical Results of Fibroid Embolisation, Trials and Registries. In: Reidy, J., Hacking, N., McLucas, B. (eds) Radiological Interventions in Obstetrics and Gynaecology. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2012_642

Download citation

  • DOI: https://doi.org/10.1007/174_2012_642

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-27974-4

  • Online ISBN: 978-3-642-27975-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics