03:00 PM Abstract No. 131 Uterine artery patency after embolization: a prospective study and multivariate analysis

Abstract

Patency of the uterine arteries after embolization may have important implications for women with future fertility wishes. We aimed to investigate if certain embolic agents achieved a greater patency rate whilst not compromising on infarct achieved. A prospective study of 124 patients undergoing uterine fibroid embolization (UFE) at a single centre was conducted. Multivariate analysis was performed to compare the uterine artery patency rates of six different embolic agents; PVA, Embozene, Beadblock, Embosphere, Gelfoam, Optisphere. The ANOVA multivariate analysis adjusted for factors including operator, dominant fibroid volume, uterine volume, patient age. Bonferri statistical adjustment was performed. Ordinal regression analysis was conducted to assess for differences in fibroid infarct percentage (classified as 100% infarct, 90-99% and <90%). Baseline patient characteristics were similar to previous studies (mean age 44.8, Uterine volume 579.8 cm3, dominant fibroid volume 249.0 cm3) with no significant difference between the embolic groups. Optisphere (adjusted marginal mean uterine artery patency 83.9%), Embosphere (68.3%) embozene (94.5%), beadblock (91.8%), and PVA (88.9%) all demonstrated similar levels of artery patency following multivariate analysis with no statistically significant difference between these embolic agents (p=1.0 after Bonferri adjustment). Optisphere demonstrated a greater level of vessel patency compared with Gelfoam 83.9% vs 14.0% (mean difference 69.9, p=0.001). All embolic agents demonstrated similar levels of dominant fibroid (DF) and all fibroid (AF) infarct (Optisphere vs other particles; DF odds ratio 0.28- 1.3 p=0.19-0.81, AF odds ratio 0.18-2.0 p=0.23-0.67). Most embolic agents achieved similar levels of uterine artery patency after embolization, other than Gelfoam which had a higher rate of uterine artery occlusion.