The vascular impact of uterine artery embolization: prospective sonographic assessment of ovarian arterial circulation.
OBJECTIVE
The etiology of premature ovarian failure after uterine artery embolization (UAE) is unknown. The authors prospectively assessed ovarian arterial circulation before and after UAE with use of ultrasonography (US). The authors hypothesize that nontarget embolization of the ovary occurs during routine UAE.


METHODS
Twenty-three women (mean age of 42.6 years; range, 35-51 y) participated in the study. Grayscale, color, and pulsed-wave Doppler US studies were performed immediately before and after UAE. Resistive index (RI) and pulsatility index (PI) were calculated. The proportion of women who developed increased vascular impedance after UAE was statistically assessed with use of the Yates-corrected chi(2) test.


RESULTS
Seventeen of 23 patients (74%) completed the study. Nine of 17 (54%) showed complete loss of ovarian arterial perfusion after UAE. Six of 17 (35%) had increases in RI and PI, whereas two of 17 (11%) had decreases in RI and PI. The increase in vascular impedance after UAE in 15 of 17 patients was significant (P <.0001).


CONCLUSIONS
Loss of detectable ovarian arterial perfusion occurs in the majority of patients undergoing UAE. Ovarian vascular impedance increases in nearly all patients as a result of UAE. The authors conclude that inadvertent nontarget embolization of the ovarian arterial bed occurs during routine UAE.
Ryu
R K
RK
Section of Vascular and Interventional Radiology, Northwestern University Medical School, Northwestern Memorial Hospital, Chicago, IL 60611, USA. rkryu@hotmail.com
Chrisman
H B
HB
Omary
R A
RA
Miljkovic
S
S
Nemcek
A A
AA
Saker
M B
MB
Resnick
S
S
Carr
J
J
Vogelzang
R L
RL
D000328:Adult; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000628:therapy; D008875:Middle Aged; D010053:Ovary / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011446:Prospective Studies; D012039:Regional Blood Flow; D018615:Ultrasonography, Doppler, Color; D014594:Uterine Neoplasms / Q000628:therapy; D014599:Uterus / Q000098:blood supply