title: Efficacy of Ovarian Artery Embolization for Uterine Fibroids: Clinical and Magnetic Resonance Imaging Evaluations.
abstract: OBJECTIVE
  The objective of the study was to assess the efficacy of ovarian artery embolization (OAE) treatment for symptomatic uterine leiomyomas.
  
  
  METHODS
  A retrospective review of 17 patients who underwent OAE in conjunction with uterine artery embolization in a 6-year period (2006-2012) was performed. Ten patients had previous failed embolization, while 7 had not received any embolization therapy before. Percent uterine volume change, percent dominant fibroid volume change, and percent dominant fibroid infarction were assessed with magnetic resonance (MR) imaging. Resolution of menorrhagia, dysmenorrhea/pain, and bulk and/or pressure symptoms including urinary frequency were evaluated clinically. Change in menopausal state was also an outcome of interest.
  
  
  RESULTS
  Mean MR imaging follow-up was performed 3 months post-OAE. MR images showed complete infarction in the majority of cases (64.7%; n = 11), with infarction rates of 90%-100% in 3 cases, 1 case with 30%-50% infarction, and 2 cases with 0%-10% infarction. Average uterine size reduction on MR was 32.3% (95% confidence interval [CI]: 22.5%-42.2%; P < .001). The average size reduction for the dominant fibroid was 42.4% (95% CI: 27.7%-57.0%; P = .01). The mean time to final follow-up visit was 11 months. At this point complete symptom resolution (menorrhagia, dysmenorrhea and bulk-related) was achieved in 82.4% (n = 14) of cases. At the final follow-up 11.8% (n = 2) of cases reported menopause.
  
  
  CONCLUSIONS
  We observed OAE to be an effective and safe adjunct to uterine artery embolization when hypertrophic ovarian artery(ies) require intervention. However, incomplete fibroid infarction of 23% remains a concern with a potential for long-term treatment failure. In addition, long-term effect on ovarian function is uncertain.
authors.affiliation: Division of Interventional Radiology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Campbell
authors.affiliation: Division of Interventional Radiology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Dheeraj K
authors.initials: DK
authors.lastname: Rajan
authors.affiliation: Division of Interventional Radiology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: John R
authors.initials: JR
authors.lastname: Kachura
authors.affiliation: Division of Interventional Radiology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Jaskolka
authors.affiliation: Division of Interventional Radiology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: J Robert
authors.initials: JR
authors.lastname: Beecroft
authors.affiliation: Division of Interventional Radiology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Kenneth W
authors.initials: KW
authors.lastname: Sniderman
authors.affiliation: Division of Interventional Radiology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Martin E
authors.initials: ME
authors.lastname: Simons
authors.affiliation: Division of Interventional Radiology, University Health Network, University of Toronto, Toronto, Ontario, Canada. Electronic address: kongteng.tan@uhn.ca.
authors.forename: Kong T
authors.initials: KT
authors.lastname: Tan
mesh_terms: D000328:Adult; D001158:Arteries; D004412:Dysmenorrhea / Q000209:etiology; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D059411:Lower Urinary Tract Symptoms / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008593:Menopause; D008595:Menorrhagia / Q000209:etiology; D008875:Middle Aged; D010053:Ovary / Q000098:blood supply*; D011859:Radiography; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome; D047368:Tumor Burden; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*
keywords: Embolization; Gonadal artery; Magnetic resonance imaging; Uterine fibroid