Five-year clinical outcomes of uterine artery embolization for symptomatic leiomyomas: An analysis of risk factors for reintervention

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

Research output: Contribution to journalArticle

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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

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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, Man Deuk ; 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.",
author = "Yoon, {Ja Kyung} and Kichang Han and Kim, {Man Deuk} and Kim, {Gyoung Min} and Kwon, {Joon Ho} and Won, {Jong Yun} and Lee, {Do Yun}",
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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, Man Deuk; Kim, Gyoung Min; Kwon, Joon Ho; Won, Jong Yun; Lee, Do Yun.

In: European Journal of Radiology, Vol. 109, 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, Man Deuk

AU - Kim, Gyoung Min

AU - Kwon, Joon Ho

AU - Won, Jong Yun

AU - Lee, Do Yun

PY - 2018/12

Y1 - 2018/12

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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