Five-year clinical outcomes of uterine artery embolization for symptomatic leiomyomas

An analysis of risk factors for reintervention

Ja Kyung Yoon, Kichang Han, ManDeuk Kim, Gyoung Min Kim, Joon Ho Kwon, Jong Yun Won, Do Yun Lee

Research output: Contribution to journalArticle

Abstract

Objectives: The objective of this study is to investigate the five-year reintervention rate of uterine artery embolization (UAE) for symptomatic leiomyomas and to identify potential predictive factors of reintervention. Methods: From March 2011 to February 2012, 92 consecutive women (mean age 41.9 years, range 28–55 years) underwent bilateral UAE. Contrast-enhanced magnetic resonance imaging (MRI) was performed at three-month follow-up. After annual follow-up, a survey on clinical outcome and reintervention incidences was performed at five-year follow-up. Potential predictive factors of reintervention were evaluated. Results: Of the 67 patients, menorrhagia and/or bulk-related symptoms were resolved after UAE in all but one patient (98.5%). At median follow-up of 60 months (range, 5–60 months), reintervention rate was 10.4%, with seven reintervention cases (five myomectomy and two hysterectomy cases). Complete (100%) or near complete (90–99%) infarction rate of the dominant leiomyoma was 96.4% (54 of 56). Independent factors of reintervention on multivariate logistics regression analysis included near complete or partial (<90%) infarction of the dominant leiomyoma (odds ratio [OR] 22.238; 95% confidence interval [CI] 2.405–205.620; p = 0.006), as well as the presence of non-dominant viable leiomyomas (OR 12.134; 95% CI 1.213–121.409; p = 0.034). Conclusion: UAE provides excellent and sustained symptom improvement of symptomatic leiomyomas with a low reintervention rate at five-year follow-up. In addition to near complete or partial infarction of the dominant leiomyoma on follow-up MRI, the presence of viable non-dominant leiomyomas indicates a higher risk of reintervention.

Original languageEnglish
Pages (from-to)83-87
Number of pages5
JournalEuropean Journal of Radiology
Volume109
DOIs
Publication statusPublished - 2018 Dec 1

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Uterine Artery Embolization
Leiomyoma
Infarction
Uterine Myomectomy
Odds Ratio
Magnetic Resonance Imaging
Confidence Intervals
Menorrhagia
Hysterectomy
Logistic Models
Regression Analysis
Incidence

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Yoon, Ja Kyung ; Han, Kichang ; Kim, ManDeuk ; Kim, Gyoung Min ; Kwon, Joon Ho ; Won, Jong Yun ; Lee, Do Yun. / Five-year clinical outcomes of uterine artery embolization for symptomatic leiomyomas : An analysis of risk factors for reintervention. In: European Journal of Radiology. 2018 ; Vol. 109. pp. 83-87.
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title = "Five-year clinical outcomes of uterine artery embolization for symptomatic leiomyomas: An analysis of risk factors for reintervention",
abstract = "Objectives: The objective of this study is to investigate the five-year reintervention rate of uterine artery embolization (UAE) for symptomatic leiomyomas and to identify potential predictive factors of reintervention. Methods: From March 2011 to February 2012, 92 consecutive women (mean age 41.9 years, range 28–55 years) underwent bilateral UAE. Contrast-enhanced magnetic resonance imaging (MRI) was performed at three-month follow-up. After annual follow-up, a survey on clinical outcome and reintervention incidences was performed at five-year follow-up. Potential predictive factors of reintervention were evaluated. Results: Of the 67 patients, menorrhagia and/or bulk-related symptoms were resolved after UAE in all but one patient (98.5{\%}). At median follow-up of 60 months (range, 5–60 months), reintervention rate was 10.4{\%}, with seven reintervention cases (five myomectomy and two hysterectomy cases). Complete (100{\%}) or near complete (90–99{\%}) infarction rate of the dominant leiomyoma was 96.4{\%} (54 of 56). Independent factors of reintervention on multivariate logistics regression analysis included near complete or partial (<90{\%}) infarction of the dominant leiomyoma (odds ratio [OR] 22.238; 95{\%} confidence interval [CI] 2.405–205.620; p = 0.006), as well as the presence of non-dominant viable leiomyomas (OR 12.134; 95{\%} CI 1.213–121.409; p = 0.034). Conclusion: UAE provides excellent and sustained symptom improvement of symptomatic leiomyomas with a low reintervention rate at five-year follow-up. In addition to near complete or partial infarction of the dominant leiomyoma on follow-up MRI, the presence of viable non-dominant leiomyomas indicates a higher risk of reintervention.",
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Five-year clinical outcomes of uterine artery embolization for symptomatic leiomyomas : An analysis of risk factors for reintervention. / Yoon, Ja Kyung; Han, Kichang; Kim, ManDeuk; Kim, Gyoung Min; Kwon, Joon Ho; Won, Jong Yun; Lee, Do Yun.

In: European Journal of Radiology, Vol. 109, 01.12.2018, p. 83-87.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Five-year clinical outcomes of uterine artery embolization for symptomatic leiomyomas

T2 - An analysis of risk factors for reintervention

AU - Yoon, Ja Kyung

AU - Han, Kichang

AU - Kim, ManDeuk

AU - Kim, Gyoung Min

AU - Kwon, Joon Ho

AU - Won, Jong Yun

AU - Lee, Do Yun

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Objectives: The objective of this study is to investigate the five-year reintervention rate of uterine artery embolization (UAE) for symptomatic leiomyomas and to identify potential predictive factors of reintervention. Methods: From March 2011 to February 2012, 92 consecutive women (mean age 41.9 years, range 28–55 years) underwent bilateral UAE. Contrast-enhanced magnetic resonance imaging (MRI) was performed at three-month follow-up. After annual follow-up, a survey on clinical outcome and reintervention incidences was performed at five-year follow-up. Potential predictive factors of reintervention were evaluated. Results: Of the 67 patients, menorrhagia and/or bulk-related symptoms were resolved after UAE in all but one patient (98.5%). At median follow-up of 60 months (range, 5–60 months), reintervention rate was 10.4%, with seven reintervention cases (five myomectomy and two hysterectomy cases). Complete (100%) or near complete (90–99%) infarction rate of the dominant leiomyoma was 96.4% (54 of 56). Independent factors of reintervention on multivariate logistics regression analysis included near complete or partial (<90%) infarction of the dominant leiomyoma (odds ratio [OR] 22.238; 95% confidence interval [CI] 2.405–205.620; p = 0.006), as well as the presence of non-dominant viable leiomyomas (OR 12.134; 95% CI 1.213–121.409; p = 0.034). Conclusion: UAE provides excellent and sustained symptom improvement of symptomatic leiomyomas with a low reintervention rate at five-year follow-up. In addition to near complete or partial infarction of the dominant leiomyoma on follow-up MRI, the presence of viable non-dominant leiomyomas indicates a higher risk of reintervention.

AB - Objectives: The objective of this study is to investigate the five-year reintervention rate of uterine artery embolization (UAE) for symptomatic leiomyomas and to identify potential predictive factors of reintervention. Methods: From March 2011 to February 2012, 92 consecutive women (mean age 41.9 years, range 28–55 years) underwent bilateral UAE. Contrast-enhanced magnetic resonance imaging (MRI) was performed at three-month follow-up. After annual follow-up, a survey on clinical outcome and reintervention incidences was performed at five-year follow-up. Potential predictive factors of reintervention were evaluated. Results: Of the 67 patients, menorrhagia and/or bulk-related symptoms were resolved after UAE in all but one patient (98.5%). At median follow-up of 60 months (range, 5–60 months), reintervention rate was 10.4%, with seven reintervention cases (five myomectomy and two hysterectomy cases). Complete (100%) or near complete (90–99%) infarction rate of the dominant leiomyoma was 96.4% (54 of 56). Independent factors of reintervention on multivariate logistics regression analysis included near complete or partial (<90%) infarction of the dominant leiomyoma (odds ratio [OR] 22.238; 95% confidence interval [CI] 2.405–205.620; p = 0.006), as well as the presence of non-dominant viable leiomyomas (OR 12.134; 95% CI 1.213–121.409; p = 0.034). Conclusion: UAE provides excellent and sustained symptom improvement of symptomatic leiomyomas with a low reintervention rate at five-year follow-up. In addition to near complete or partial infarction of the dominant leiomyoma on follow-up MRI, the presence of viable non-dominant leiomyomas indicates a higher risk of reintervention.

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