Uterine artery embolization in the primary treatment of uterine leiomyomas: Technical features and prospective follow-up with clinical and sonographic examinations in 58 patients

OBJECTIVE, The purpose of this study was to analyze the technical features of uterine artery embolization and to evaluate the effectiveness of this me thod as the primary treatment of uterine leiomyomas in a series of 58 patie nts monitored by clinical and sonographic examinations. SUBJECTS AND METHODS. Fifty-eight women (age range, 33-65 years; mean age, 44.5 years) with symptoms caused by uterine leiomyomas (abnormal bleeding, bulk-related symptoms, pelvic pain) were included in this prospective study , We performed embolization with a single catheter using the single-femoral artery approach, injection of particles (150-250 mm), and an absorbable ge latin sponge. Postprocedural pain was assessed using a visual analog scale. Systematic follow-up included clinical and sonographic examinations at 3 m onths for 58 patients, at 6 months for 46 patients, at 1 year for 27 patien ts, and at 2 pears for seven patients. RESULTS. Embolization was performed without problems in 84% of the patients . Post-procedural pain control was excellent in 90% of the patients. In mos t patients, symptoms were improved or had resolved at 3 months (90%), 6 mon ths (92%). and 1 year (93%), and all patients were symptom-free at 2 years. Clinical failure of treatment occurred in only two patients (3%), Progress ive reduction in leiomyoma size was revealed during sonographic follow-up, and new leiomyomas were seen in one patient at 2 years. CONCLUSION. Uterine artery embolization is an endovascular method for the t reatment of uterine leiomyomas that is clinically effective in most patient s and that induces a progressive reduction in the size of the largest leiom yomas.