Bilateral versus unilateral femoral access for uterine artery embolization: results of a randomized comparative trial.
OBJECTIVE
To determine if uterine embolization via bilateral femoral puncture reduces fluoroscopy time with a similar frequency of puncture site complications compared with unilateral puncture.


METHODS
Patients presenting for uterine artery embolization (UAE) for leiomyomata at a single institution were randomly assigned to receive unilateral or bilateral femoral punctures. Procedures were performed in a standardized fashion. Patients were blinded to the puncture site with an opaque dressing. Outcome measures included fluoroscopy time, dose-area product (DAP), procedure time, and puncture site pain after treatment. Baseline characteristics of the two groups and outcome measures were compared with the use of t tests, analyses of variance, Pearson chi(2) tests, and nonparametric tests.


RESULTS
Fifty-seven patients consented to participate: 22 received bilateral punctures and 35 received unilateral puncture. Bilateral puncture procedures had less fluoroscopy time (13 minutes vs 16.6 minutes; P = .0033), less procedure time (54.9 min vs 62.9 min; P = .026), and fewer angiographic images (46.5 vs 68.3; P < .001). There was no difference in DAP (12,986 muGy/cm(2)for bilateral vs 16,237 muGy/cm(2)for unilateral; P = .35). Groins that were punctured had greater-although still minor-pain than unpunctured groins at 24 hours (visual analog pain scores, 1.45 for punctured groins vs 0 for unpunctured groins; P = .039) and 48 hours (scores of 1 vs 0; P = .018). There were no complications in either group.


CONCLUSIONS
Bilateral femoral puncture during UAE was associated with reduced fluoroscopy time and procedure time, minor puncture site pain, and no increase in complications.
Costantino
Mary
M
Department of Radiology, Georgetown University Medical Center, CG 201, 3800 Reservoir Road NW, Washington, DC 20007-2113, USA.
Lee
Justin
J
McCullough
Michael
M
Nsouli-Maktabi
Hala
H
Nsrouli-Maktabi
Hala
H
Spies
James B
JB
D000328:Adult; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D007889:Leiomyoma / Q000628:therapy*; D008875:Middle Aged; D011677:Punctures / Q000379:methods; D011829:Radiation Dosage; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D055357:Uterine Artery Embolization / Q000379:methods*; D014594:Uterine Neoplasms / Q000628:therapy*; D055815:Young Adult