Uterine Artery Embolization for Pedunculated Subserosal Leiomyomas: Evidence of Safety and Efficacy

Yong Seek Kim, Kim YS, Kichang Han, Kim MD, Man Deuk Kim, Man-Deuk Kim, Gyoung Min Kim, Kim GM, Joon Ho Kwon, Junhyung Lee, Lee J, Woosun Choi, Choi W, Jong Yun Won, Do Yun Lee, Lee DY
Journal of vascular and interventional radiology : JVIR · 2018 · vol. 29(4) , pp. 497–501 · doi:10.1016/j.jvir.2017.11.022 · PMID:29477623 · W2788557794
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This paper provides evidence for the safety and efficacy of uterine artery embolization as a treatment for pedunculated subserosal leiomyomas.

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Abstract

PurposeTo evaluate safety and efficacy of uterine artery embolization (UAE) for pedunculated subserosal (PS) leiomyomas.Materials and methodsOf 1,069 patients who underwent UAE for symptomatic leiomyomas or adenomyosis from 2007 to 2016, 55 patients (mean age 40.3 y ± 4.8) with 66 PS leiomyomas (mean diameter 6.61 cm ± 2.04) were enrolled. Each PS leiomyoma was categorized into 1 of 2 groups: high-risk PS leiomyoma (stalk diameter < 25% of diameter of leiomyoma) and low-risk PS leiomyoma (stalk diameter 25%-50% of diameter of leiomyoma). MR imaging was performed 3 months after UAE. Rates of infarction and volume reduction were compared between PS leiomyomas and non-PS dominant leiomyomas and between high-risk and low-risk PS leiomyomas. Complications related to PS leiomyomas were assessed.ResultsAt a median follow-up of 96 days (range, 36-348 d) after UAE, none of the patients (0%) had complications related to PS leiomyomas, even among high-risk cases. Mean volume reductions of 38.2% and 38.4% were achieved for PS leiomyomas and non-PS dominant leiomyomas, respectively (P = .953). There were 3 (5.5%) minor adverse events, but none were related to PS leiomyoma. There was no significant difference in volume reduction and infarction rates between low-risk and high-risk PS leiomyomas.ConclusionsUAE is safe and effective in patients with PS leiomyomas even for high-risk cases (stalk diameter < 25% of diameter of leiomyoma). PS leiomyoma should not be considered a contraindication for UAE.

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MeSH descriptors

Leiomyoma Uterine Artery Embolization Uterine Neoplasms Adult Female Humans Leiomyoma Magnetic Resonance Imaging Middle Aged Radiography, Interventional Retrospective Studies Treatment Outcome Uterine Artery Embolization Uterine Neoplasms

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