Keywords:
Genital / Reproductive system female, Interventional vascular, Pelvis, Catheter arteriography, Percutaneous, Embolisation, Catheters, Efficacy studies, Outcomes
Authors:
T. D'hoore, A. Laenen, K. Op de beeck, D. Timmerman, G. Maleux; Leuven/BE
DOI:
10.26044/ecr2019/C-0844
Methods and materials
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 of the dominant fibroma and total uterine volume was calculated by multiplanar segmentation [7].
Ultrasound data was used in the remaining 31 patients.
Uterine volume and dominant fibroma volume in these patients was calculated using the formula for an ellipsoid volume.
Symptom-related data was obtained by postal questionnaire to define symptom severity,
reintervention rate and to asses post procedural fertility.
The questionnaire,
with a total of 36 questions,
was based upon the UFS-QOL questionnaire [8] and interrogated symptoms pre-intervention and post-intervention.
Patients were asked to score their symptoms on a 5-point Likert scale (1 = no impact,
5 = very much impacted). We used the formula suggested by J.
Spies et al [8] to calculate a symptom severity score,
where higher score values indicate a greater symptom severity and lower scores indicate minimal severity.
The inverted formula was used to calculate a quality of life score,
including parameters for sexual dysfunction,
limitations in social life and depressed mood.
Higher scores indicate better quality of life.
Data analysis
One patient died of non-related causes in the follow-up period.
189 questionnaires were sent and 128 questionnaires returned of which 23 questionnaires because of unknown address changes.
Ten questionnaires were not fully completed.
A total of 95 completed questionnaires are received (fig2).
Statistical analysis
A statistical analysis of anonymized patient characteristics between responders and non-responders was done,
using SAS 9.4 statistical software,
by Chi-square test for categorical variables and Mann-Whitney U test for continuous variables.
A p-value of less than 0.05 was considered significant [9].
There were no significant differences between patients who completed the questionnaire and patients who did not return a fully completed one.