Pooja J Sheth, Presenter: Nothing to Disclose

James B. Spies MD, Abstract Co-Author: Research Consultant, Boston Scientific Corporation Research Consultant, Merit Medical Systems, Inc Research Consultant, Cook Group Incorporated Research Consultant, CeloNova BioSciences, Inc

To determine what risk factors might predispose a woman to leiomyoma expulsion after uterine artery embolization (UAE).

This was a retrospective chart review of 500 patients who underwent uterine artery embolization for symptomatic leiomyomata. Each patient had a minimum of a 6 month interval from the procedure at the time of analysis. Potential risk factors for leiomyoma expulsion were recorded at the time of the procedure and included: patient age, patient race, uterine volume, dominant leiomyoma volume, dominant leiomyoma location, number of leiomyomata, type and amount of embolic material used, whether or not the ovarian artery was also embolized, and prior gynecologic surgery. Any complications that that these patients experienced were found by examining reports from the three-month post-procedure follow-up phone call, as well as outpatient, inpatient, and emergency room records. We preformed a regression analysis to determine which of these risk factors, if any, were associated with leiomyoma passage and/or hysterectomy.

A total of 23 women of the 500 participants (4.6%) experienced a complication after the UAE procedure that indicated leiomyoma passage. Leiomyoma volume was associated with passage, with larger diameter leiomyomata having a higher likelihood of passage (OR 1.2). Number of leiomyomata was also associated with leiomyoma passage, where women with greater than 1 leiomyoma were less likely to experience leiomyoma passage (i.e. 2-5 leiomyomata OR 0.29, 6-10 OR 0.25, >10 OR 0.17). There was no significant association found for hysterectomy (n=7).

Leiomyoma volume and number of leiomyomata in the uterus are associated with leiomyoma expulsion after UAE, where the larger the leiomyoma and the fewer leiomyomata the patient has, the more likely she is to experience expulsion.

Based on these results, women who have few large leiomyomata can be followed closer post-operatively to prevent from the potential negative sequelae of leiomyoma expulsion.

Sheth, P, Spies, J, Risk Factors for Fibroid Expulsion after Uterine Artery Embolization.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11003590.html