Is uterine artery embolization for patients with large myomas safe and effective? A retrospective comparative study in 323 patients

Purpose: To evaluate the effectiveness, safety, and complications of uterine artery embolization (UAE) in women with large fibroid tumors. Materials and Methods: From January 2005 to February 2011, 323 patients underwent UAE for symptomatic uterine leiomyomas without adenomyosis and were included in this study. Patients were divided into two groups: those with a large tumor burden (group 1; n = 63), defined as a dominant tumor with a longest axis of at least 10 cm or a uterine volume of at least 700 cm³; and the control group (group 2; n = 260). Tumor infarction and volume reduction were calculated based on magnetic resonance imaging findings. Symptom status was assessed with a visual analog scale. Postprocedure complications and repeat interventions were recorded. The data were analyzed with appropriate statistical tests. Results: No significant differences were seen between the two groups in volume reduction of dominant tumors (46.5% in group 1 vs 52.0% in group 2; P =.082) or percentage volume reduction of the uterus (40.7% in group 1 vs 36.3% in group 2; P =.114). Also, no significant differences were seen between the two groups regarding satisfaction scores at immediate or midterm follow-up (P =.524 and P =.497) or in the presence of procedure-related complications (P =.193). Conclusions: UAE outcomes in large fibroid tumors were comparable to those in smaller tumors, without an increased risk of significant complications. Tumor size may not be a key factor in predicting successful outcomes of UAE.