The safety and efficacy of a percutaneous closure device in patients undergoing uterine artery embolization.
OBJECTIVE
The use of suture-mediated closure devices (SMCDs) in patients undergoing uterine artery embolization (UAE) for symptomatic leiomyomata is controversial. With recent literature suggesting a higher complication rate with the use of SMCDs, their use in this specific population has been questioned. The purpose of this study is to assess the safety and efficacy of SMCDs specifically for those patients undergoing UAE for symptomatic uterine leiomyomata.


METHODS
A prospective database was established in a single high-volume medical center for patients undergoing UAE for symptomatic leiomyomata. Data were tracked prospectively, with technical outcome and complication rates serving as endpoints.


RESULTS
UAE was performed in 342 consecutive patients from January 2001 to September 2003. The SMCD was used in 328 of these patients (96%). Successful primary hemostasis was achieved in 320 of 328 patients (97%), with additional manual compression required in the remaining eight patients (3%). No major complications were observed. Minor complications consisted of minor hematomas in four women (1%) and anteriomedial thigh pain in 68 women (21%) within 1 month of follow-up, resulting in an overall complication rate of 22%. All symptoms related to anteromedial thigh pain ipsilateral to the arterial puncture site were managed conservatively with 1 week of oral nonsteroidal antiinflammatory medication.


CONCLUSIONS
The SMCD provided safe and effective hemostasis in patients undergoing UAE. Transient thigh discomfort, which may result from irritation of the anterior femoral cutaneous nerves (femoral neuralgia syndrome), was uniformly relieved with nonsteroidal antiinflammatory therapy.
Chrisman
Howard B
HB
Department of Radiology, Interventional Radiology Section, Northwestern University, Northwestern Memorial Hospital, Illnois, Chicago, USA.
Liu
David M
DM
Bui
James T
JT
Resnick
Scott A
SA
Sato
Kent
K
Chen
Richard
R
Vogelzang
Robert L
RL
Omary
Reed A
RA
D000328:Adult; D016461:Chemoembolization, Therapeutic / Q000295:instrumentation*; D005260:Female; D006489:Hemostatic Techniques; D006801:Humans; D007889:Leiomyoma / Q000628:therapy*; D008875:Middle Aged; D011446:Prospective Studies; D012449:Safety; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000628:therapy*; D014599:Uterus / Q000098:blood supply*