Transradial uterine artery embolization for the treatment of symptomatic fibroids: A ten year experience
Year: 2025
Type: article
Study design: Observational Study
Abstract: Uterine fibroids are the most frequent tumors in women. They are generally asymptomatic but can cause bleeding problems and/or compression of neighboring structures, as well as infertility. Embolization is an effective treatment for treating fibroids, but transradial access is underused for various reasons. The purpose of this study is to demonstrate that transradial access is safe and effective for the treatment of symptomatic uterine fibroids to avoid conventional surgery. a single-center retrospective observational study was conducted reviewing medical records between 2012 and 2022 in which 189 procedures were planned in patients with symptomatic uterine fibroids with fulfilled gestational desire. The feasibility and safety of the technique, the need for subsequent surgery due to lack of effectiveness of the treatment in women who could complete it from the date of the procedure until 24 months later, changes in uterine volume and in the largest fibroid as well as in hemoglobin levels, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) were analyzed before and six months after the procedure. Changes in the quality of life questionnaire (UFS-QoL) were analyzed before embolization, as well as two and six months after. 184 procedures out of 189 attempted (97.35%) were performed with total or partial angiographic success. Surgical intervention was not necessary 24 months after the procedure in 85.4% of the patients (158/180 patients with complete angiographic success) with a very low rate of complications, all of them mild (7%; 13/185). Between the first visit and the visit at six months post-intervention, both the uterine volume decreased (n= 176; previous vol. 458.11cc, 6 months after vol. 311.87cc; -146.24cc 95% confidence interval (-115.41; -177.06) p<0.001) as well as the largest fibroid (previous 132.31cc, 6 months after vol. 78.33 cc; -(-53.98 cc 95% confidence interval (-42.79; -65.17) p <0.001) and the scores in the quality of life questionnaires and the hemoglobin level improved (previous 11.4 g/dL, 6 months after 12.85 g/dL; -9.94 95% confidence interval (-1.74; -1.16) p<0.001). FSH (previous 18.61, 6 months after 30.68; -4.18 95% confidence interval (-6.35; -17.77) p <0.001) and LH (previous 13.52, 6 months after 20.91; -3.60 95% confidence interval -3.60 (-3.31; -11.45)p <0.001) levels were elevated but estradiol (previous 97.98, 6 months after 99.01; 0.11 95% confidence interval (-32.40; 28.84)) levels were not affected. the transradial approach should be adopted as a safe and effective alternative for the treatment of symptomatic uterine fibroids in patients with fullfilled gestational desire.
Source: AJOG Global Reports
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,980
OpenAlex ID: W4415336671