Markers of muscle ischemia, necrosis, and inflammation following uterine artery embolization in the treatment of symptomatic uterine fibroids.
OBJECTIVE
The objective of the study was to quantify markers of myometrial ischemia, necrosis, and inflammation in women undergoing uterine artery embolization (UAE).


METHODS
Women with symptomatic fibroids were randomized to treatment with UAE (n = 14) or abdominal myomectomy (n = 11). Peripheral venous blood samples were taken before and after the procedure, at 24 hours and 6 weeks. Creatine kinase (CK) and ischemia-modified albumin (IMA) were measured as markers of necrosis and ischemia. Inflammation was assessed by measurement of C-reactive protein (CRP).


METHODS
Changes in the markers following UAE and myomectomy were measured.


RESULTS
Following UAE, no change was seen in CK or IMA, but CRP was raised only at 6 weeks. At 24 hours after myomectomy, there were significant rises in all 3 markers, with a return to normal by 6 weeks.


CONCLUSIONS
No significant ischemia or necrosis occurs in the myometrium following UAE, whereas the delayed rise in CRP is likely to reflect necrosis in fibroids.
Banu
Nassera S
NS
Department of Clinical Development Sciences, St. George's University of London, London, United Kingdom.
Gaze
David C
DC
Bruce
Helen
H
Collinson
Paul O
PO
Belli
Anna-Maria
AM
Manyonda
Isaac T
IT
D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D003402:Creatine Kinase / Q000097:blood*; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D004716:Endometritis / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D007511:Ischemia / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D007889:Leiomyoma / Q000097:blood / Q000098:blood supply / Q000601:surgery / Q000628:therapy*; D009215:Myometrium / Q000098:blood supply* / Q000473:pathology*; D009336:Necrosis; D012709:Serum Albumin / Q000032:analysis*; D014594:Uterine Neoplasms / Q000097:blood / Q000098:blood supply / Q000601:surgery / Q000628:therapy*
D015415:Biomarkers; D012709:Serum Albumin; D002097:C-Reactive Protein; D003402:Creatine Kinase