OC7.07: Uterine artery Doppler flow velocity following uterine fibroid embolization

Abstract

To evaluate the relation of uterine artery (UA) Doppler flow velocity indices with volume reduction of uterine fibroids following embolization. Seventeen women underwent embolization due to one or more of the following symptoms and signs: menorrhagia (n = 13), frequency of voiding (n = 9) and sensation of pressure (n = 14). Median age was 47 years (range 30–52). Bilateral Doppler flow velocity measurements were performed before and within four days after embolization. The size and localization of the fibroids were assessed on MRI examinations before, at 3 months and at one year after the procedure. After selective catheterization of both UAs through a unilateral femoral access, bilateral embolization was obtained by injection of polyvinyl alcohol particles under intermittent fluoroscopic guidance until complete cessation of flow. Evaluation of the pulsatility index (PI) was separate for the right and left UAs and for the dominant UA dependent on fibroid localization (right, n = 10; left, n = 4). The mean PI value of both arteries was used if none was judged to be dominant (n = 3). Nonparametric statistical tests were used. The PI values increased from before to after embolization with median values (25th—75th centiles) of 1.37 (1.06–2.46) vs. 2.49 (1.30–3.04) on the right side (p = 0.08), 1.86 (1.43–2.63) vs. 2.29 (1.15–3.47) on the left side (p = 0.33) and 1.39 (1.16–2.54) vs. 2.49 (1.18–3.28) in the dominant UA (p = 0.01). The individual change in PI values (PI after–PI before) was highly correlated to the percentage decrease in fibroid size at 3 months (n = 12) for the dominant (r = 0.73, p = 0.01) and right UA (r = 0.75, p = 0.01), but not for the left side. No significant correlations were observed between the PI changes and fibroid size at one year (n = 13). This pilot study showed that the changes in the PI values of the UAs at the time of embolization was related to short term but not long term reduction in fibroid size.