PREDICTing Post-Embolization Syndrome after uterine fibroid embolization: the PREDICT-PES study.

Area of Science:

• Interventional Radiology
• Gynecology
• Vascular Medicine

Background:

• Uterine artery embolization (UAE) is a common treatment for symptomatic uterine fibroids.
• Post-embolization syndrome (PES) is a known complication, but rates of clinically significant PES (csPES) and associated risk factors require further elucidation.

Purpose of the Study:

• To determine the incidence of csPES in patients undergoing UAE for symptomatic fibroids.
• To identify patient-specific risk factors predictive of csPES development.

Main Methods:

• Retrospective case-control study including 69 patients who underwent UAE for symptomatic fibroids.
• csPES defined by pain score >5, elevated PCA morphine use, fever, or multiple antiemetics.
• Logistic regression analysis used to identify risk factors.

Main Results:

• The overall rate of csPES was 47.8% (33/69 patients).
• Nulliparity was significantly associated with an increased risk of csPES (OR: 5.51, P=.021).
• A trend suggested older age may be associated with a reduced risk of csPES (OR: 0.87, P=.054).

Conclusions:

• csPES is a frequent complication following UAE for fibroids.
• Nulliparity emerges as a novel and significant risk factor for csPES.
• Findings can inform pre-procedure patient counseling and targeted interventions for high-risk individuals.