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. 2025 Mar;132(4):518-528.
doi: 10.1111/1471-0528.18023. Epub 2024 Dec 1.

Risk Factors of Complications After Uterine Artery Embolisation for Symptomatic Fibroids: A Case-Control Study

Adeline de Wit  1 , Marc-Florent Tassi  2 , Denis Herbreteau  3 , Henri Marret  4
Affiliations

Risk Factors of Complications After Uterine Artery Embolisation for Symptomatic Fibroids: A Case-Control Study

Adeline de Wit et al. BJOG. 2025 Mar.

Abstract

Objective: We aim to clarify potential risk factors of complications after uterine artery embolisation (UAE).

Setting: Complications after uterine artery embolisation (UAE) for symptomatic fibroids are rare, but failure of treatment occurs for approximately 13%-24% of patients at 10 years.

Design: We conducted a case-control study including all complications post UAE over 15 years in our specialised unit.

Population: All Grade 2 complications (or worse) for the Society of Interventional Radiology Standards of Practice Committee complications post UAE were considered. One thousand one hundred seventy-two UAE were performed.

Methods: Complications were divided into two groups: early (< 1 month) or late (≥ 1 month) to differentiate complications from failure of procedure. Multinomial analysis was conducted to assess links between complications and potential risk factors.

Results: Sixty-nine (0.06%) complications were found: 24.6% hospitalisation for pain (n = 17/69), 30.4% for infection (n = 21/69) and 2.9% expulsion of fibroid (n = 2/69). Overall, 31 patients underwent a second procedure (45%).

Main outcome measures: Intra-uterine device and multiple fibroids were strongly related to early complications (ORearly = 4.44, IC 95%: 1.5-13.3 and ORearly = 3.7, IC 95%: 1.2-11.3, respectively). The only factor that appeared to be associated with risk of early and late complications was the major fibroid's diameter (for an increased size of 25 mm, ORearly = 1.7, IC 95%: 1.1-2.6; ORlate = 1.5, IC 95%: 1.04-2.2).

Conclusion: Our study enlightens about the potential risk factors of UAE's complications and differentiate their impact between early and late complications.

Keywords: complications; fibroids; risk factors; uterine artery complications.

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Conflict of interest statement

The ICMJE were provided. Pr Herbreteau and Pr Marret have a past of conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart. UAE: Uterine artery embolisation.
FIGURE 2
FIGURE 2
Results of adjusted analysis (imputed data). IUD, Intra‐uterine device, OR, Odds ratio.
See this image and copyright information in PMC

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