Repeat uterine artery embolization: indications and technical findings.
OBJECTIVE
To determine the indications and technical aspects of procedures in patients undergoing repeat uterine artery embolization (UAE).


METHODS
At a single center, 24 patients underwent repeat embolization for recurrent or persistent symptoms. The magnetic resonance (MR) imaging findings before repeat embolization were compared with those of earlier studies. The extent of tumor infarction after the first procedure was determined, and the status of existing or new tumors before the second procedure was assessed. The angiographic studies from the initial and repeat embolization studies were reviewed and summarized. These findings were assessed with the use of summary statistics.


RESULTS
Twenty-four patients underwent repeat embolization 6-66 months after the initial embolization. The most common symptom at representation was pressure and/or bulk symptoms (n=15), followed by recurrent heavy bleeding (n=12) and pelvic pain or cramping (n=7). MR imaging studies before repeat embolization revealed incomplete infarction of tumors present before the first embolization in 22 of 24 patients. New tumors were identified in 12 patients, two of whom had new tumors only. During repeat embolization, nine patients (37%) required ovarian artery embolization to occlude ovarian supply to the uterus. Among 21 women with clinical follow-up after the second embolization, 19 (90%) had symptom control.


CONCLUSIONS
Repeat embolization prompted by recurrent uterine leiomyomas usually occurs in the setting of regrowth of incompletely infarcted tumors. Although ovarian embolization was often needed, on the basis of this limited experience, symptoms appear to respond well to repeat embolization.
Yousefi
Shadi
S
Department of Radiology, CG 201, Georgetown University Hospital, 3800 Reservoir Road Northwest, Washington, DC 20007-2113, USA.
Czeyda-Pommersheim
Ferenc
F
White
Amy M
AM
Banovac
Filip
F
Hahn
Winnie Y
WY
Spies
James B
JB
D000328:Adult; D000792:Angiography; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005781:Gelatin Sponge, Absorbable; D006801:Humans; D007889:Leiomyoma / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000628:therapy*; D014599:Uterus / Q000098:blood supply*