Study Supports UFE in Fibroids Larger Than 10 cm

October 7, 2015—In a study of uterine fibroid embolization published in CardioVascular and Interventional Radiology (CVIR), Viktor Bérczi, MD, et al concluded that there was no significant difference in the effectiveness of uterine artery embolization (UAE) and the number of minor and major complications between fibroids with largest diameter < 10 cm compared to those > 10 cm (2015;38:1152–1156).

According to the investigators, early literature suggested that the size of the uterus, the size of the dominant fibroid, and the amount of applied embolization particles would be risk factors for major postprocedural complications, but recent publications have confuted these early results. The purpose of the study was to evaluate whether the size of the dominant fibroid would influence the complication rate and effectiveness of UAE in a large single-center cohort.

As summarized in CVIR, 303 patients had UAE from April 28, 2008 to December 31, 2012; 262 patients had small fibroids (group 1, largest diameter < 10 cm), 41 patients had large fibroids (group 2, largest diameter > 10 cm). UAE was performed from unilateral femoral access using 500 to 710 µm and 355 to 500 µm polyvinyl alcohol particles. Periprocedural and postprocedural complications and numeric analog quality of life scores (0 = unbearable symptoms; 100 = perfect quality of life) were listed and statistically analyzed.

During the mean follow-up time (7.79 ± 5.16 months), data on 275 of the 303 patients (90.8%) were available. Quality of life score was 33.3 ± 23.5 and 33.5 ± 24.1 before UAE and 85.6 ± 16.0 and 81.5 ± 23.5 after UAE in group 1 and group 2, respectively (Mann-Whitney U test one-sided, P = .365). Group 1 reported four myoma expulsions, one acute myomectomy, and two acute hysterectomies, while group 2 documented one myoma expulsion, one acute myomectomy, and two acute hysterectomies (nonsignificant differences), reported the investigators in CVIR.