Technical success rate, peri-interventional complications and radiation exposure of the transarterial embolization for leiomyomas of the uterus

Purpose: To analyze the technical success rate, incidence and type of peri-interventional complications, and radiation exposure of uterine artery embolization (UAE) in symptomatic leiomyomas of the uterus. Materials and Methods: This prospective study includes 75 patients consecutively treated with UAE from October 2000 through August 2002, with all interventions performed by the same radiologist. Technical success rate, interventional material, and incidence and type of peri-interventional complications (length of hospitalization) were recorded and categorized according to the definitions of the Society of Interventional Radiology (SIR). Fluoroscopy time (FT), dose-area product (DAP), and effective dose (ED) were determined for each intervention and the influence of the radiologist's experience on the radiation exposure analyzed. Results: UAE was technically successful in 97.3% of the cases. Peri-interventional complications occurred in 14.7%. Four complications (5.3%) were classified as major class C according to the SIR (post-embolization syndrome requiring prolonged drug treatment and hospitalization [n=3] perforation of the uterine artery [ n = 1]). None of the complications led to discontinuation of the intervention, subsequent surgical intervention, or permanent sequelae. FT decreased significantly (p<0.05) until the 35th intervention. The median FT decreased from 18.8 min (13.4 - 28 min [25th to 75th percentile]) to 11.8 min (9.7 - 13.3 min [25th to 75th percentile]). The DAP decreased by 25.3% to a median of 8.547 (6.527-11.590 cGy*CM2 [25th to 75th percentile]). The median ED was 31.5 mSv from the 36th intervention onward. Conclusion: UAE has a high technical success rate with a low rate of peri-interventional complications. The study showed a statistically significant learning effect with a decrease in radiation exposure for the first 35 interventions. The effective dose of UAE is comparable to that of I to 2 small bowel enema.