Bilateral versus unilateral femoral access for uterine artery embolization: results of a randomized comparative trial

To determine if uterine embolization via bilateral femoral puncture reduces fluoroscopy time with a similar frequency of puncture site complications compared with unilateral puncture.

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.

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.

Bilateral femoral puncture during UAE was associated with reduced fluoroscopy time and procedure time, minor puncture site pain, and no increase in complications.