title: Complication rates and effectiveness of uterine artery embolization in the treatment of symptomatic leiomyomas: a systematic review and meta-analysis.
abstract: OBJECTIVE
  The purpose of this meta-analysis was to determine the rates of major complications, other associated adverse events, reintervention, and clinical improvement from studies reporting complications of uterine artery embolization (UAE) for the treatment of symptomatic leiomyomas.
  
  
  METHODS
  PubMed, Medline, Embase, and Cochrane databases were searched for publications on the treatment of leiomyomas by UAE. Data pertaining to study characteristics, numbers of complications, symptomatic improvement, and reinterventions were collected by two readers. Pooled event rates were calculated using a random effects method.
  
  
  RESULTS
  Fifty-four study populations met the inclusion criteria, yielding a total of 8159 patients. There were no reported deaths. Major complications occurred at a rate of 2.9% (95% CI, 2.2-3.8%). The rate of hysterectomy for resolution of a complication from UAE was 0.7% (0.5-0.9%), and the rate of readmission was 2.7% (1.9-3.7%). Multiple other specific complications were recorded including leiomyoma tissue passage (4.7% [3.9-5.7%]), deep venous thrombosis or pulmonary embolism (0.2% [0.2-0.4%]), and permanent amenorrhea (3.9% [2.7-5.3%]). Reintervention rates including repeat UAE, myomectomy, or hysterectomy calculated per patient-year occurred at 5.3% (4.2-6.4%) with follow-up ranging from 0.25 to 5 years. Clinical symptomatic improvement ranged from 78% to 90%, with follow-up ranging from 0.25 to 2 years.
  
  
  CONCLUSIONS
  Symptomatic uterine leiomyoma treatment by UAE is an effective procedure with a low rate of major complications supporting its use as an alternative to hysterectomy.
authors.affiliation: Department of Medical Imaging, The Ottawa Hospital and University of Ottawa, Civic Campus, 1053 Carling Ave, Rm C120, Ottawa, ON K1Y 4E9, Canada. sundeepstoor@gmail.com
authors.forename: Sundeep S
authors.initials: SS
authors.lastname: Toor
authors.forename: Arash
authors.initials: A
authors.lastname: Jaberi
authors.forename: D Blair
authors.initials: DB
authors.lastname: Macdonald
authors.forename: Mathew D F
authors.initials: MD
authors.lastname: McInnes
authors.forename: Mark E
authors.initials: ME
authors.lastname: Schweitzer
authors.forename: Pasteur
authors.initials: P
authors.lastname: Rasuli
mesh_terms: D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000628:therapy*; D019233:Retreatment; D055357:Uterine Artery Embolization / Q000009:adverse effects / Q000379:methods*; D014594:Uterine Neoplasms / Q000628:therapy*