Hysterectomy for complications after uterine artery embolization for leiomyoma: results of a Canadian multicenter clinical trial.
OBJECTIVE
To determine the complication-related hysterectomy rate after uterine artery embolization (UAE) for symptomatic uterine leiomyomas.


METHODS
Prospective, multicenter, nonrandomized, single-arm clinical trial (Canadian Task Force classification II-2).


METHODS
Eight Ontario University-affiliated teaching and community hospitals.


METHODS
Five hundred fifty-five women.


METHODS
Polyvinyl alcohol particles were delivered through a catheter into uterine arteries under fluoroscopic guidance.


RESULTS
Prospective follow-up investigations consisted of telephone interviews, ultrasound examinations, and reviews of pathology and surgery reports. Median follow-up was 8.1 months, and all but five patients had complete 3-month follow-up. At 3 months, eight women (1.5%, 95% CI 0.6-2.8) underwent complication-related hysterectomy. Half of the surgeries were performed at institutions other than where UAE had been performed. Indications for hysterectomies were infections (2), postembolization pain (4), vaginal bleeding (1), and prolapsed leiomyoma (1).


CONCLUSIONS
The 3-month complication rate resulting in hysterectomy after UAE in a large cohort of women was low. Hysterectomy after UAE is an important measure of safety and a key outcome measure of this new therapy.
Pron
Gaylene
G
Department Public Health Sciences, Faculty of Medicine, University of Toronto, 100 College Street, Room 513 Banting Building, Toronto, Ontario M5G 1L5, Canada.
Mocarski
Eva
E
Cohen
Marsha
M
Colgan
Terence
T
Bennett
John
J
Common
Andrew
A
Vilos
George
G
Kung
Rose
R
D000328:Adult; D016001:Confidence Intervals; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007889:Leiomyoma / Q000175:diagnosis / Q000628:therapy*; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016037:Single-Blind Method; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000628:therapy*; D014599:Uterus / Q000098:blood supply*