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Fertility Outcomes After Uterine Artery Embolization for Symptomatic Uterine Arteriovenous Malformations: A Single-Center Retrospective Study in 33 Women

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Abstract

Purpose

To describe the clinical and fertility outcomes after uterine artery embolization (UAE) for symptomatic uterine arteriovenous malformations (AVMs).

Materials and Methods

This single-center retrospective study included 33 patients with uterine AVMs who underwent UAE at our institution between May 2013 and May 2021. The inclusion criteria were diagnostic features of uterine AVM as detection of the nidus and early venous drainage on angiography. The exclusion criteria were high levels of beta-human chorionic gonadotropin indicative of gestational trophoblastic neoplasia. Polyvinyl alcohol (PVA) with a diameter of 500–700 µm (with or without Gelfoam/Glue) was used in 32 procedures and, Glue (with lipiodol) was used in one. The patients were followed up for 31 months (range, 6–90 months). Angiograms, medical records, and phone interviews were used to describe the technical and clinical success, complications, and pregnancy outcomes.

Results

Thirty-three patients with a mean age of 31.2 ± 5.4 years (range, 21–42 years) were included in this case series. Technical success was reported in all patients (100%). Bleeding control was also achieved in 32 (96%) patients. Pelvic and puncture site pain and groin hematoma were reported as minor complications (grade 1 according to CIRSE classification). Six pregnancies (33%) occurred after uterine artery embolization. Four women had full-term pregnancies without complications and delivered healthy newborns. Another two women were in the second trimester of pregnancy with a favorable fetal condition. No post-embolization miscarriage was reported.

Conclusion

The UAE is safe and effective in controlling vaginal bleeding caused by uterine AVMs, allowing successful future pregnancies.

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

    Hossein Ghanaati, Kavous Firouznia, Behnaz Moradi & Selda Behestani

  2. Department of Radiology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Behnaz Moradi

Authors
  1. Hossein Ghanaati
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  2. Kavous Firouznia
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  3. Behnaz Moradi
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  4. Selda Behestani
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Corresponding author

Correspondence to Selda Behestani.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Ghanaati, H., Firouznia, K., Moradi, B. et al. Fertility Outcomes After Uterine Artery Embolization for Symptomatic Uterine Arteriovenous Malformations: A Single-Center Retrospective Study in 33 Women. Cardiovasc Intervent Radiol 45, 983–991 (2022). https://doi.org/10.1007/s00270-022-03105-2

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  • DOI: https://doi.org/10.1007/s00270-022-03105-2

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