%0 Journal Article
%T Complications Associated with Uterine Artery Embolisation for Fibroids
%A Maria Memtsa
%A Hayden Homer
%J Obstetrics and Gynecology International
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/290542
%X Uterine artery embolisation (UAE) is a relative newcomer to the mainstream treatment modalities available for fibroid-related problems. The efficacy of UAE is indisputable and has been shown to be comparable to hysterectomy in the short term in large-scale trials. Moreover, compared with hysterectomy, UAE is less invasive, carries a superior risk profile, and, importantly, preserves the uterus. UAE therefore offers patients symptom relief whilst at the same time retaining reproductive potential. Notably however, although women can have successful pregnancies following UAE, it is becoming increasingly evident that pregnancies after UAE are more risky especially during the early stages. Long-term outcome data from randomised trials involving UAE have very recently become available and show that whilst high satisfaction rates previously identified during early-stage followup are sustained, one notable drawback is a substantial risk of reintervention. It remains to be seen how this facet of UAE will impact on its future uptake. 1. Introduction The occlusion of the vascular supply of uterine fibroids, uterine artery embolisation (UAE), was first described in 1995 [1] and is now firmly established as a minimally invasive organ-preserving approach for treating symptomatic uterine fibroids. Short term followup data from randomised controlled trials have established UAE as a safe and effective alternative to hysterectomy for alleviating fibroid-related disorders such as menorrhagia and pressure symptoms [2]. However, a fuller appreciation of the longer term efficacy and complications of UAE is only just becoming apparent. Therefore, although gaining in popularity, it is important that patients be apprised of these emerging data so that they will be well equipped to make informed decisions regarding the suitability of this treatment modality. This paper will summarise the reported side effects, complications, and symptom recurrence rate, not only in the short term but, as 5-year followup data are starting to emerge, also in the long term. We will also review the available evidence regarding the adverse effects of UAE on fertility and pregnancy outcome. 2. Technical Aspects and Periprocedural Side Effects of UAE UAE exploits the differential recovery ability between fibroids and normal uterine tissue in response to ischaemia that is induced at the arteriolar level [3]. Using a femoral artery approach, the uterine artery is catheterised thereby allowing for the injection of embolic particles, most often made of poly-vinyl alcohol (PVA), that disrupt the blood
%U http://www.hindawi.com/journals/ogi/2012/290542/