Inferior Mesenteric Artery Collaterals to the Uterus during Uterine Artery Embolization: Prevalence, Risk Factors, and Clinical Outcomes

Suyon Chang, Mu Sook Lee, Man Deuk Kim, Chang Jin Yoon, Dae Chul Jung, Myungsu Lee, Sung Il Park, Jong Yoon Won, Do Yun Lee
Journal of vascular and interventional radiology : JVIR · 2013 · doi:10.1016/j.jvir.2013.05.049 · PMID:23891048
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

The inferior mesenteric artery was the second most common source of uterine collaterals (1.3%), more frequent in patients with adenomyosis and larger uterine volumes, leading to high treatment failure rates during uterine artery embolization.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This retrospective study analyzed 559 women who underwent uterine artery embolization (UAE) for MRI-diagnosed uterine fibroids or adenomyosis (2008–2011) to assess the prevalence of inferior mesenteric artery (IMA) collaterals to the uterus, risk factors, and clinical outcomes, using post-embolization aortography with selective angiography when collaterals were suspected. IMA collaterals were found in 1.3% of patients (second most common source overall), and their presence was independently associated with adenomyosis (odds ratio 19.556) and larger baseline uterine volume. Among the seven patients with IMA collaterals, embolization was not attempted in six and clinical failure occurred in four, with improvement reported in one patient after IMA embolization with coils. The study’s key limitation is its retrospective design and limited follow-up data for the small number of IMA-collateral cases. This paper is centrally about adenomyosis — it reports that adenomyosis, more than fibroids alone, is an independent risk factor for IMA collaterals during UAE linked to higher treatment failure.

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Abstract

PURPOSE: To evaluate the prevalence of inferior mesenteric artery (IMA) collaterals to the uterus found during uterine artery embolization (UAE), associated risk factors, and clinical outcomes. MATERIALS AND METHODS: The records of 559 women who underwent UAE during the period 2008-2011 for uterine fibroids or adenomyosis found on magnetic resonance imaging were retrospectively analyzed. If IMA collaterals to the uterus were suspected on aortography performed after embolization, selective angiography was performed. Risk factors for IMA collaterals to the uterus were analyzed, including the presence of adenomyosis, baseline uterine volume, or prior pelvic surgery. RESULTS: Collaterals to the uterus were found from the ovarian artery (n = 21; 3.8%), IMA (n = 7; 1.3%), round ligament artery (n = 1; 0.2%), and internal pudendal artery (n = 1; 0.2%). IMA collaterals were found in seven patients. Of 185 patients, 6 (3.2%) had adenomyosis, with or without fibroids, which was significantly more frequent than the 1 (0.27%) of 374 patients who had fibroids only (P = .006). On multiple logistic regression analysis, the presence of adenomyosis (odds ratio, 19.556; P = .0168) and uterine volume (odds ratio, 1.003; P = .0069) were independent factors for the presence of IMA collaterals. Of the seven patients with IMA collaterals, embolization was not attempted in six, resulting in clinical failure in four. One patient who underwent IMA embolization with coils experienced clinical improvement. CONCLUSIONS: The IMA was the second most common (1.3%) source of collaterals to the uterus. IMA collaterals were more frequent in patients with adenomyosis than in patients with fibroids only, resulting in high frequency of treatment failure.
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Materials and methods

The records of 559 women who underwent UAE during the period 2008-2011 for uterine fibroids or adenomyosis found on magnetic resonance imaging were retrospectively analyzed. If IMA collaterals to the uterus were suspected on aortography performed after embolization, selective angiography was performed. Risk factors for IMA collaterals to the uterus were analyzed, including the presence of adenomyosis, baseline uterine volume, or prior pelvic surgery.

Results

Collaterals to the uterus were found from the ovarian artery (n = 21; 3.8%), IMA (n = 7; 1.3%), round ligament artery (n = 1; 0.2%), and internal pudendal artery (n = 1; 0.2%). IMA collaterals were found in seven patients. Of 185 patients, 6 (3.2%) had adenomyosis, with or without fibroids, which was significantly more frequent than the 1 (0.27%) of 374 patients who had fibroids only (P = .006). On multiple logistic regression analysis, the presence of adenomyosis (odds ratio, 19.556; P = .0168) and uterine volume (odds ratio, 1.003; P = .0069) were independent factors for the presence of IMA collaterals. Of the seven patients with IMA collaterals, embolization was not attempted in six, resulting in clinical failure in four. One patient who underwent IMA embolization with coils experienced clinical improvement.

Conclusions

The IMA was the second most common (1.3%) source of collaterals to the uterus. IMA collaterals were more frequent in patients with adenomyosis than in patients with fibroids only, resulting in high frequency of treatment failure. - Appears in Collections: - 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

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Condition tags

adenomyosis

MeSH descriptors

Leiomyoma Leiomyoma Mesenteric Arteries Uterine Artery Uterine Artery Embolization Uterine Neoplasms Uterine Neoplasms Adenomyosis Adenomyosis Adenomyosis Adult Causality Female Humans Leiomyoma Leiomyoma Mesenteric Arteries Middle Aged Prevalence Radiography

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