The vascular impact of uterine artery embolization: Prospective sonographic assessment of ovarian arterial circulation

Purpose: The etiology of premature ovarian failure after uterine artery emb olization (UAE) is unknown. The authors prospectively assessed ovarian arte rial circulation before and after UAE with use of ultrasonography (US). The authors hypothesize that nontarget embolization of the ovary occurs during routine UAE. Materials and methods: Twenty-three women (mean age of 42.6 years; range, 3 5-51 y) participated in the study. Grayscale, color, and pulsed-wave Dopple r US studies were performed immediately before and after UAE. Resistive ind ex (RI) and pulsatility index (PI) were calculated. The proportion of women who developed increased vascular impedance after UAE was statistically ass essed with use of the Yates-corrected chi (2) test. Results: Seventeen of 23 patients (74%) completed the study. Nine of 17 (54 %) showed complete loss of ovarian arterial perfusion after UAE. Six of 17 (35%) had increases in RI and PI, whereas two of 17 (11%) had decreases in RI and PI. The increase in vascular impedance after UAE in 15 of 17 patient s was significant (P<.0001). Conclusion: Loss of detectable ovarian arterial perfusion occurs in the maj ority of patients undergoing UAE. Ovarian vascular impedance increases in n early all patients as a result of UAE. The authors conclude that inadverten t nontarget embolization of the ovarian arterial bed occurs during routine UAE.