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Outcomes After Unilateral Uterine Artery Embolization: A Retrospective Review

  • Clinical Investigation
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Abstract

Purpose

Bilateral uterine artery embolization (UAE) is considered necessary to provide effective treatment for symptomatic uterine fibroids. Occasionally, only unilateral embolization is performed, and this study evaluates these outcomes.

Materials and Methods

As part of a prospective observational study of more than 1600 patients treated with UAE since 1996, there have been 48 patients in whom unilateral embolization has been performed. This study retrospectively reviews clinical response as assessed by our standard questionnaire and radiological response assessed by either magnetic resonance imaging or ultrasound.

Results

Two principal groups emerged: the largest, where only the dominant unilateral arterial supply was electively embolized (30 patients); and the second, where there was technical failure to catheterize the second uterine artery as a result of anatomical constraints (12 patients). Favorable clinical response with a reduction in menorrhagia at 1 year was seen in 85.7% (18/21) of those patients with a dominant arterial supply to the fibroid(s). In contrast, in those patients where there was technical failure to embolize one uterine artery, there was a high rate of clinical failure requiring further intervention in 58.3% (7/12). Comparison of the technical failure group with the dominant uterine artery group demonstrated a statistically significant (Fisher’s exact test) difference in the proportion of patients with evidence of persistent fibroid vascularity (p < 0.001) and requiring repeat intervention (p < 0.01).

Conclusion

We conclude that unilateral UAE can achieve a positive clinical result in the group of patients where there is a dominant unilateral artery supplying the fibroid(s), in contrast to the poor results seen following technical failure.

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Acknowledgments

We would like to acknowledge our deepest gratitude to Rose Nielsen, Research Assistant, for her dedicated and exhaustive work on the data for this article; without her endeavor and commitment, it would not have been possible.

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Authors and Affiliations

  1. Radiology Department, St George’s Hospital, Blackshaw Road, London, SW17 OQT, UK

    M. J. Bratby

  2. Radiology Department, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, GU2 7XX, UK

    F. F. Hussain & W. J. Walker

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  1. M. J. Bratby
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  2. F. F. Hussain
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  3. W. J. Walker
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Correspondence to W. J. Walker.

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Bratby, M.J., Hussain, F.F. & Walker, W.J. Outcomes After Unilateral Uterine Artery Embolization: A Retrospective Review. Cardiovasc Intervent Radiol 31, 254–259 (2008). https://doi.org/10.1007/s00270-007-9092-8

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  • DOI: https://doi.org/10.1007/s00270-007-9092-8

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