Effectiveness of elective unilateral uterine artery embolization: a case-control study

To evaluate the effectiveness of elective unilateral uterine artery embolization (UAE) in limited fibroid disease.

A review of 1,431 UAE recipients at a single institution identified 76 who underwent unilateral embolization, most in the setting of anatomic variants or technical failure. A total of 28 had intentional unilateral UAE because of unilateral disease on magnetic resonance (MR) imaging with supply from only the ipsilateral uterine artery on angiography. These 28 case-group patients were compared with a control group of 28 patients who underwent bilateral UAE contemporaneously. Outcome measures included a chief symptom resolution score, fluoroscopy time, tumor infarction rate, patient satisfaction, analgesia requirements, and maximum pain score. Baseline characteristics and outcome measures were compared with t tests, Pearson χ(2) tests, analyses of variance, and nonparametric tests.

Three-month clinical follow-up and postprocedure MR imaging were available for 25 of the case-group patients. The unilateral UAE group had fewer analgesia doses demanded (28.8 vs 57.5; P = .049), lower total analgesia dose (22.8 mg vs 34.5 mg; P = .029), shorter fluoroscopy time (10.9 min vs 13.4 min; P = .013), and lower maximum pain score (3.7 vs 5.7; P = .003). There were no differences in chief symptom resolution score (2.1 vs 1.9; P = .27), satisfaction score (4.0 vs 4.0; P = .72), or complete tumor infarction (92% vs 88%; P = .64).

Unilateral UAE in appropriately selected patients has similar clinical results as standard bilateral UAE and is associated with reduced fluoroscopy time and postprocedural pain.