The aim of this study is evaluation of treatment failure (TF), defined as the necessity for second intervention, after uterine artery embolization (UAE) for symptomatic fibroids in a long-term follow-up, up to 16 years. Multiple short- and mid-term studies have been published, but only a few studies were available with patient follow-up over ten years [1]. Secondary outcomes parameters are identification of possible patient-specific predictors of TF and evaluation of post-procedural fertility. There have been multiple case reports of pregnancies after UAE [2, 3, 4,...

Patient population This single-center retrospective cohort study included 190 patients who underwent UAE between 2001 and 2016. The embolization was done by selective catheterization of both uterine arteries through unilateral femoral access and injection of trisacryl gelatin microspheres (500µm-700µm and 700µm-900µm) distally in the uterine arteries in all patients (fig1). Data acquisition Patient characteristics were extracted from the patient files. 159 patients underwent an MRI prior to intervention. This data was used to evaluate the number of fibromas and locate the dominant fibroma. The volume...

Treatment failure and symptom control Time between intervention and follow-up ranges from 1.2 to 15.2 years with a mean follow-up period of 6.1 years. Improvement of clinical symptoms was achieved in 72 out of 95 patients (75.79%), based on the non-validated questionnaire. The mean pre-procedural symptom severity score was 47.15 [QR; 35.00-62.50] and 17,06 [QR; 7.5-22.5] after embolization. This is a reduction in symptoms of 63,83% (p <0.0001). The mean quality of life score before intervention was 73.05 [QR; 58.33-92.71] and 89.54 [QR; 83.33-100] after...

This long-term follow-up study supports UAE as a good, long-term treatment option for symptomatic fibroids. Larger size uterus or dominant fibroma is correlated with higher failure rates and can possibly be used as a parameter for patient selection in order to increase treatment success. Fertility outcomes from this study demonstrate the possibility to become pregnant and deliver after UAE.

1. Hamoda H, Pepas L, Tasker F, Reidy J, Khalaf Y (2015) Intermediate and long-term outcomes following uterine artery fibroid embolization. Eur J Obstet Gynecol Reprod Biol 191:33-38. 2. Poulsen B, Munk T, Rav P (2011) Long-term follow up after uterine artery embolization for symptomatic uterine leiomyomas. Acta Obstet Gynecol Scand 90:1281-1283 3. Ravina JH, Vigneron NC, Aymard A, Le Dref O, Merland JJ (2000) Pregnancy after embolization of uterine myoma: Report of 12 cases. Fertil Steril 73:1241-1243 4. Iversen H, Dueholm M (2017) Radiofrequency...