Uterine artery embolization: a vascular surgery procedure? One vascular surgery group's experience

Uterine artery embolization (UAE) has been performed by interventional radiology since the 1990s for symptomatic uterine fibroids with considerable success. Endovascular-trained vascular surgeons possess the necessary skills to successfully perform this procedure after an adequate but brief training period. Fourteen successful UAE procedures were performed by two vascular surgeons over a one-year period. Indications for the procedures were bleeding (12/14 patients, 86%), pain/bloating/pressure (13/14 patients, 93%) and dyspareunia (2/14 patients, 14%). All patients were initially evaluated by a gynecologist and referred for this procedure. Complications were minor and limited. Clinical follow-up demonstrated near-complete to complete symptom resolution in all but one patient for a 93% short-term success rate. Follow-up ultrasound studies demonstrated a reduction in the uterine fibroid size in all patients three months or more postprocedure. The mean fibroid size reduction was 4.07-3.26 cm (20%), P < 0.005. UAE is a procedure of proven benefit, well-matched to many vascular surgeons' skills and practice. Up to this point, few vascular surgeons have incorporated this endovascular procedure into their practices. This initial and somewhat limited study demonstrates one vascular surgery group's early success with this procedure.