Risk of intrauterine infectious complications after uterine artery embolization.
OBJECTIVE
To identify risk factors for the development of intrauterine infection following uterine artery embolization.


METHODS
A retrospective review of uterine artery embolizations (UAE) performed for the treatment of symptomatic fibroids from January 2000 to July 2003 was conducted. With logistic regression and the Fisher exact test, multiple variables were analyzed as predictors for intrauterine infectious complications requiring medical and/or surgical therapy, including the use of preprocedural antibiotics, embolic agent used, quantity of embolic material, location of fibroids (submucosal, nonsubmucosal), and size and location of the dominant fibroid.


RESULTS
A total of 414 UAE procedures were performed in 410 patients with a technical success rate of 99%. Average age of the patient cohort was 42.8 years (SD, 5.8 years). One hundred forty-eight patients (36.1%) had submucosal fibroids or fibroids projecting submucosally, 262 patients (63.9%) had nonsubmucosal fibroids. Intrauterine infectious complications requiring intravenous antibiotic therapy and/or surgery occurred in five patients (1.2%). A total of five infectious complications requiring therapy occurred in the submucosal group (3.4%) and none in the nonsubmucosal group. Patients within the submucosal group were more likely to develop intrauterine infectious complications than patients with nonsubmucosal fibroids based on univariate analysis (P = .006) but with logistic regression, the association was not significant (P = .079). No significant difference with embolic agent, quantity of embolic particles, use of preprocedure antibiotics, or size of or location of the dominant fibroid was found.


CONCLUSIONS
No specific risk factor for intrauterine infection following UAE was identified in this study. Infection after UAE is rare and appears to be a sporadic occurrence. Nevertheless, close surveillance is warranted in all women following UAE given the potential morbidity of this complication.
Rajan
Dheeraj K
DK
Division of Vascular and Interventional Radiology, Department of Medical Imaging, Mount Sinai Hospital-University of Toronto, Toronto, Ontario M5G 2N2, Canada. dheeraj.rajan@uhn.on.ca
Beecroft
John R
JR
Clark
Timothy W I
TW
Asch
Murray R
MR
Simons
Martin E
ME
Kachura
John R
JR
Sved
Michael
M
Sniderman
Kenneth W
KW
D000328:Adult; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000098:blood supply / Q000000981:diagnostic imaging / Q000628:therapy*; D016015:Logistic Models; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D014463:Ultrasonography; D014591:Uterine Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000382:microbiology*; D014594:Uterine Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000628:therapy*; D014599:Uterus / Q000098:blood supply* / Q000382:microbiology