Outcomes after uterine artery embolization for pedunculated subserosal leiomyomas.
OBJECTIVE
To assess the safety and efficacy of uterine artery embolization (UAE) treatment of pedunculated subserosal leiomyomas.


METHODS
A review of patients undergoing UAE in a 30-month period (July 2004 to December 2006) was performed. Cases in which a pedunculated subserosal tumor (volume>or=4 cm3) was embolized were analyzed. The preprocedural volumes of the pedunculated tumor and uterus and the diameter and vascularity of the tumor and stalk were recorded. Posttreatment sizes of the pedunculated leiomyoma, stalk, and uterus were recorded, as was the presence or absence of complication(s).


RESULTS
A total of 240 patients underwent embolization. Pedunculated subserosal leiomyomas were treated in 16 women, with a technical success rate of 100%. Preprocedural mean tumor and uterine volumes were 372 cm3 and 789 cm3, respectively. The mean stalk diameter was 2.7 cm (range, 0.8-7.8 cm). All pedunculated leiomyomas exhibited enhancement on contrast agent-enhanced magnetic resonance (MR) imaging (n=13) or vascularity on Doppler ultrasonography (US; n=3). Stalk vascularity was noted on MR imaging in 13 patients and was not assessed in the remaining three, who underwent US imaging. Imaging follow-up (mean, 5.9 months after UAE) demonstrated mean tumor volume reduction of 39.3% (95% confidence interval [CI], 28.2%-50.5%) and mean uterine volume reduction of 37.6% (95% CI, 26%-49.3%). There were no cases of continued tumor perfusion and no major complications. There was one minor complication of prolonged hospital stay (36 hours) for pain control.


CONCLUSIONS
UAE was successfully and safely performed for pedunculated subserosal leiomyomas, with a tumor volume reduction of 39% and no unique complications related to these lesions.
Margau
Ryan
R
Department of Medical Imaging, North York General Hospital, University of Toronto, 4001 Leslie Street, Toronto Ontario, Canada M2K 1E1. ryan.margau@utoronto.ca
Simons
Martin E
ME
Rajan
Dheeraj K
DK
Hayeems
Eran B
EB
Sniderman
Kenneth W
KW
Tan
Kongteng
K
Beecroft
J Robert
JR
Kachura
John R
JR
D000328:Adult; D001158:Arteries; D003287:Contrast Media; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000473:pathology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D012189:Retrospective Studies; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014594:Uterine Neoplasms / Q000473:pathology / Q000628:therapy*; D014599:Uterus / Q000098:blood supply*
D003287:Contrast Media