title: Utero-ovarian anastomoses and their influence on uterine fibroid embolization.
abstract: OBJECTIVE
  To correlate clinical outcomes after uterine artery embolization (UAE) performed to treat uterine fibroids with the presence of varying types of utero-ovarian anastomoses (UOA).
  
  
  METHODS
  A retrospective analysis was performed of all uterine angiograms from 202 patients (mean age 42 y, range 28-54 y) who underwent UAE because of heavy menstrual bleeding, dysmenorrhea, or anemia or a combination of these symptoms. UOA were classified as absent or present, unilateral or bilateral. The effects of UOA on long-term outcomes (clinical endpoints such as control of bleeding and pain) and complications (amenorrhea) were assessed statistically using Kaplan-Meier curves and χ(2) and log-rank tests.
  
  
  RESULTS
  Of the UOA in 104 women, 38 anastomoses were bilateral, and 66 were unilateral. Type III was the most common type of anastomosis (66 cases) followed by type Ia (22 cases) and type Ib (18 cases); there were no type II anastomoses. Amenorrhea was reported in 27 (14%) women at 5-year follow-up after UAE (only 3% in women < 45 y old). There were 10 cases of clinical failure with a median follow-up of > 4 years. Bilateral or unilateral presence of UOA had no statistically significant effect on outcomes or on complications.
  
  
  CONCLUSIONS
  Recurrence rates, clinical failure, and amenorrhea after UAE do not seem to be influenced by the presence or absence of UOA. However, further studies are needed to confirm these findings.
authors.affiliation: Interventional Radiology Unit, Hospital Virgen de la Salud, Complejo Hospitalario de Toledo, Avda. Barber 30, 45004 Toledo, Spain. clanciego@eresmas.com
authors.forename: Carlos
authors.initials: C
authors.lastname: Lanciego
authors.forename: Isabel
authors.initials: I
authors.lastname: Diaz-Plaza
authors.forename: Juan-José
authors.initials: JJ
authors.lastname: Ciampi
authors.forename: Rafael
authors.initials: R
authors.lastname: Cuena-Boy
authors.forename: Nieves
authors.initials: N
authors.lastname: Rodríguez-Martín
authors.forename: Maria-Dolores
authors.initials: MD
authors.lastname: Maldonado
authors.forename: Olga
authors.initials: O
authors.lastname: Rodriguez-Gómez
authors.forename: Maria-Luisa
authors.initials: ML
authors.lastname: Cañete
authors.forename: Lorenzo
authors.initials: L
authors.lastname: García-García
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000209:etiology; D016009:Chi-Square Distribution; D003097:Collateral Circulation; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007889:Leiomyoma / Q000098:blood supply / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D008875:Middle Aged; D016017:Odds Ratio; D010053:Ovary / Q000098:blood supply*; D010146:Pain / Q000209:etiology; D011859:Radiography; D012008:Recurrence; D012039:Regional Blood Flow; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome; D055988:Uterine Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D055357:Uterine Artery Embolization / Q000009:adverse effects; D014592:Uterine Hemorrhage / Q000209:etiology; D014594:Uterine Neoplasms / Q000098:blood supply / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*