Joao Martins Pisco MD, Presenter: Nothing to Disclose

Sandra Marisa Duarte MD, Abstract Co-Author: Nothing to Disclose

Tiago Bilhim MD, Abstract Co-Author: Nothing to Disclose

Hugo Alexandre Meireles Rio Tinto MD, Abstract Co-Author: Nothing to Disclose

Lucia Cunha Fernandes MD, Abstract Co-Author: Nothing to Disclose

Determine the long-term outcome, and the successful pregnancy rate of uterine fibroid embolization (UFE), with MR evaluation, of a large series, in a single center.

Retrospective study includes 587 consecutive patients with symptomatic uterine fibroids who underwent UFE with PVA. The patients were followed from 36 to 81 months (median 47 months) after the procedure. Eighty two of them wanted to become pregnant. MR was performed before UFE, 6 and 12 months after the procedure. After 1 year, MR was performed in 167 patients. The overall results of embolization were evaluated by the answers to written questionnaires and by MR. Patient satisfaction results were classified as satisfied or not satisfied. UFE was considered successful if there was clinical improvement, without recurrence, fibroid total ischemia and volume reduction, or successful pregnancy with life birth.

The age of the patients ranged from 23 to 57 (mean 40.9) years. Long-term follow-up was possible in 571 women. Long-term clinical success was observed in 484 patients (84.8%) (menstrual bleeding, pain and bulk-related symptoms improved in 86.8%, 81.9% and 83.2% respectively). Satisfaction rate was 91.4%. MR showed further shrinkage of the fibroids, up to 5 years, of the complete ischemic fibroids. The mean dominant fibroid volume reduction was 61.1% and the uterus volume reduction was 53.5%. At each follow-up control time, the clinical failures were related to partial infarction and regrowth of one or more fibroids, except in 4 patients who showed new growths. The patients with clinical failure had the following treatment: repeated embolization 54 patients, hysterectomy 13 patients, myomectomy 12 patients and no treatment 8 patients. There were 34 finished successful pregnancies with life births (41.5%), 3 spontaneous abortions, 1 induced abortion. The age of the pregnant range from 29 to 43 (mean 36.8).  

UFE with PVA in patients with symptomatic leiomyomas provides long term clinical success, for most patients, high rate of successful pregnancies and continuous shrinkage of the completed ischemia fibroids up to 5 years.  

Largest series of pregnant patients after UFE with long-term follow-up

Pisco, J, Duarte, S, Bilhim, T, Rio Tinto, H, Fernandes, L, Long-term Outcome of Uterine Fibroid Embolization with Successful Pregnancy Rate .  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11004516.html