Risk Factors of Complications After Uterine Artery Embolisation for Symptomatic Fibroids: A Case-Control Study

We aim to clarify potential risk factors of complications after uterine artery embolisation (UAE).

Complications after uterine artery embolisation (UAE) for symptomatic fibroids are rare, but failure of treatment occurs for approximately 13%-24% of patients at 10 years.

We conducted a case-control study including all complications post UAE over 15 years in our specialised unit.

All Grade 2 complications (or worse) for the Society of Interventional Radiology Standards of Practice Committee complications post UAE were considered. One thousand one hundred seventy-two UAE were performed.

Complications were divided into two groups: early (< 1 month) or late (≥ 1 month) to differentiate complications from failure of procedure. Multinomial analysis was conducted to assess links between complications and potential risk factors.

Sixty-nine (0.06%) complications were found: 24.6% hospitalisation for pain (n = 17/69), 30.4% for infection (n = 21/69) and 2.9% expulsion of fibroid (n = 2/69). Overall, 31 patients underwent a second procedure (45%).

Intra-uterine device and multiple fibroids were strongly related to early complications (OR_early = 4.44, IC 95%: 1.5-13.3 and OR_early = 3.7, IC 95%: 1.2-11.3, respectively). The only factor that appeared to be associated with risk of early and late complications was the major fibroid's diameter (for an increased size of 25 mm, OR_early = 1.7, IC 95%: 1.1-2.6; OR_late = 1.5, IC 95%: 1.04-2.2).

Our study enlightens about the potential risk factors of UAE's complications and differentiate their impact between early and late complications.