title: Complications and reinterventions in uterine artery embolization for symptomatic uterine fibroids: a literature review and meta analysis.
abstract: OBJECTIVE
  To perform a literature review of the spectrum of complications associated with UAE relative to surgery and compare the risk of reintervention as well as minor, major, and overall complications.
  
  
  METHODS
  Literature review was conducted in PubMed, MEDLINE, Cochrane, and CINAHL databases, and meta-analysis was performed.
  
  
  RESULTS
  In randomized clinical trials, common complications were discharge and fever (4.00 %), bilateral uterine artery embolization (UAE) failure (4.00 %), and postembolization syndrome (2.86 %). Two trials showed a significantly decreased risk in major complications with UAE, with odds ratios (ORs) of 0.07143 (0.009426-0.5413) and 0.5196 (0.279-0.9678). None of the trials showed a significant difference in OR for minor complications of UAE. None of the trials showed a significant difference in risk for overall complications of UAE. Three trials showed a significantly increased risk for reintervention with UAE with ORs of 10.45 (2.654-41.14), 2.679 (1.289-5.564), and 9.096 (1.269-65.18). In 76 nonrandomized studies, common complications were amenorrhea (4.26 %), pain (3.59 %), and discharge and fever (3.37 %). In 41 case studies, common complications were discharge and fever (n = 22 cases), repeat UAE (n = 6 cases), and fibroid expulsion (n = 5 cases).
  
  
  CONCLUSIONS
  Overall, UAE has a significantly lower rate of major complications relative to surgery, but it comes at the cost of increased risk of reintervention in the future. Educating patients about the rate and types of complications of UAE versus surgery, as well as the potential for reintervention, should help the patient and clinician come to a reasoned decision.
authors.affiliation: Michael G. DeGroote School of Medicine, McMaster University, 1280 Main Street West, MDCL - 3107, Hamilton, ON, L8S 4K1, Canada. Jason.martin@medportal.ca
authors.forename: Jason
authors.initials: J
authors.lastname: Martin
authors.forename: Kunal
authors.initials: K
authors.lastname: Bhanot
authors.forename: Sriharsha
authors.initials: S
authors.lastname: Athreya
mesh_terms: D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000628:therapy*; D019233:Retreatment; D055357:Uterine Artery Embolization / Q000009:adverse effects* / Q000379:methods*