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Five-year clinical outcomes of uterine artery embolization for symptomatic leiomyomas: An analysis of risk factors for reintervention

Authors
 Ja Kyung Yoon  ;  Kichang Han  ;  Man-Deuk Kim  ;  Gyoung Min Kim  ;  Joon Ho Kwon  ;  Jong Yun Won  ;  Do Yun Lee 
Citation
 EUROPEAN JOURNAL OF RADIOLOGY, Vol.109 : 83-87, 2018 
Journal Title
 EUROPEAN JOURNAL OF RADIOLOGY 
ISSN
 0720-048X 
Issue Date
2018
Keywords
Embolization ; Fibroid ; Myoma ; Risk factor analysis ; Uterus
Abstract
OBJECTIVES: The objective of this study is to investigate the five-year reintervention rate of uterine artery embolization (UAE) for symptomatic leiomyomas and to identify potential predictive factors of reintervention. METHODS: From March 2011 to February 2012, 92 consecutive women (mean age 41.9 years, range 28-55 years) underwent bilateral UAE. Contrast-enhanced magnetic resonance imaging (MRI) was performed at three-month follow-up. After annual follow-up, a survey on clinical outcome and reintervention incidences was performed at five-year follow-up. Potential predictive factors of reintervention were evaluated. RESULTS: Of the 67 patients, menorrhagia and/or bulk-related symptoms were resolved after UAE in all but one patient (98.5%). At median follow-up of 60 months (range, 5-60 months), reintervention rate was 10.4%, with seven reintervention cases (five myomectomy and two hysterectomy cases). Complete (100%) or near complete (90-99%) infarction rate of the dominant leiomyoma was 96.4% (54 of 56). Independent factors of reintervention on multivariate logistics regression analysis included near complete or partial (<90%) infarction of the dominant leiomyoma (odds ratio [OR] 22.238; 95% confidence interval [CI] 2.405-205.620; p = 0.006), as well as the presence of non-dominant viable leiomyomas (OR 12.134; 95% CI 1.213-121.409; p = 0.034). CONCLUSION: UAE provides excellent and sustained symptom improvement of symptomatic leiomyomas with a low reintervention rate at five-year follow-up. In addition to near complete or partial infarction of the dominant leiomyoma on follow-up MRI, the presence of viable non-dominant leiomyomas indicates a higher risk of reintervention.
Full Text
https://www.sciencedirect.com/science/article/pii/S0720048X1830367X
DOI
10.1016/j.ejrad.2018.10.017
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Joon Ho(권준호) ORCID logo https://orcid.org/0000-0002-6178-7252
Kim, Gyoung Min(김경민) ORCID logo https://orcid.org/0000-0001-6768-4396
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Yoon, Ja Kyung(윤자경) ORCID logo https://orcid.org/0000-0002-3783-977X
Lee, Do Yun(이도연)
Han, Ki Chang(한기창) ORCID logo https://orcid.org/0000-0002-9701-9757
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/167125
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