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Uterine Artery Embolisation Provides Minimally Invasive Fibroid Reduction: Presented at SIR

By Ed Susman

WASHINGTON, DC -- March 20, 2008 -- Uterine artery embolisation can provide an option for women with uterine fibroids who have experienced a failed magnetic resonance-guided focused ultrasound fibroid reduction, researchers reported March 18 here at the 33rd Annual Meeting of the Society of Interventional Radiology (SIR 2008).

"[While] focused ultrasound is a new, exciting technique that can zap fibroids in a 3-hour procedure while the patient sleeps on the magnetic resonance imaging table, in up to 27% of cases the result of the treatment is unsatisfactory," said Alisa Suzuki, MD, Clinical Fellow in Radiology, Brigham and Women's Hospital, Boston, Massachusetts.

In a retrospective review of focused ultrasound, Dr. Suzuki and colleagues were able to identify 10 women who experienced treatment failure with the therapy at Brigham and Women's Hospital. She stated that 7 of these patients eventually opted to undergo minimally invasive uterine artery embolisation rather than myomectomy or hysterectomy.

"Our study shows that patients who develop clinical failure after focused ultrasound treatment could subsequently receive full benefit from uterine artery embolisation," Dr. Suzuki commented.

In reviewing the patients' records, Dr. Suzuki found that before undergoing fibroid reduction with focused ultrasound, the 7 women (mean age 46.9 +- 4.2 years) had fibroids with an average volume of 279 cc. A year after the focused ultrasound procedure, in the same women, the volume had increased an average of 13% to 316 cc. Following uterine artery embolisation, the fibroid volume averaged 163 cc -- a reduction of 49%. The difference in volume was statistically significant (P = .02).

The fibroids tended to expand the size of the uterus, a factor causing symptoms of pain, pelvic pressure, and heavy bleeding, Dr. Suzuki said. She noted that before undergoing focused ultrasound, the uterine volume in the 7 patients was 617 cc.

Twelve months later, for these women, the uterine volume was up to 682 cc -- an increase of 10%. After uterine artery embolisation, the uterine volume was 475 cc -- a 31% reduction that was statistically significant (P = .03).

"Patients also reported that clinical symptoms, including heavy bleeding, bulk, and pelvic pressure, were improved in all the women who opted for uterine artery embolisation," Dr. Suzuki said.

"Now we can comfortably inform patients that a focused ultrasound-treatment failure does not require a subsequent highly invasive surgery, [since] a minimally invasive procedure such as uterine artery embolisation may resolve the symptoms," she concluded.

[Presentation title: Evaluation of the Efficacy of Uterine Artery Embolization for Focused Ultrasound Surgery Therapeutic Failures. Abstract 142]

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