Incidence and risk factors for surgical intervention after uterine artery embolization.
OBJECTIVE
To determine the incidence and risk factors for surgical intervention after uterine artery embolization for symptomatic uterine fibroids.


METHODS
Electronic medical records of all patients who underwent uterine artery embolization for symptomatic uterine leiomyomata were reviewed. Logistic regression was used to identify independent risk factors for any surgical intervention and for hysterectomy alone after uterine artery embolization.


RESULTS
Uterine artery embolization was performed in 454 patients during the study period, with a median follow-up time (range) of 14 (0-128) months. Overall, 99 patients (22%) underwent any surgical intervention after uterine artery embolization in the operating room. Risk factors for any surgical intervention included younger age (P < .003), bleeding as an indication for uterine artery embolization (P < .01), presence of significant collateral ovarian vessel contribution to the uterus (P < .01), or use of 355-500 mum particles (P < .008).


CONCLUSIONS
Patients undergoing uterine artery embolization have a 22% risk for requiring additional surgical intervention, but overall uterine artery embolization is an effective minimally invasive option.
Park
Amy J
AJ
Department of Gynecology and Obstetrics, Cleveland Clinic, Cleveland, OH, USA.
Bohrer
Justin C
JC
Bradley
Linda D
LD
Diwadkar
Gouri B
GB
Moon
Eunice
E
Newman
James S
JS
Jelovsek
J Eric
JE
D000328:Adult; D017677:Age Distribution; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D015994:Incidence; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D008875:Middle Aged; D016017:Odds Ratio; D010147:Pain Measurement; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D011336:Probability; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D017211:Treatment Failure; D055357:Uterine Artery Embolization / Q000009:adverse effects / Q000379:methods*; D014592:Uterine Hemorrhage / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy