Selective Uterine Artery Embolization Research Articles

Clinicopathological Study of Uterine Leiomyomas: A Multicentric Study in Rural Population

Leiomyoma of uterus forms the most common type of benign tumor of uterus and also the most common pelvic tumor in women. The symptomatology continues to be variable. Surgery has for long been the main mode of therapy for the myomas. For women who wish to retain the uterus for future pregnancies or other reasons, myomectomy is preferred. Recent trend has been toward nonsurgical approaches like GnRH hormone analogs/agonists, RU 486, or selective uterine artery embolization, laparoscopic cryoablation, radiofrequency thermal ablation, and MRGUs. This multicentric study was an attempt to analyze the clinicopathological spectrum in cases of leiomyoma of the uterus at Cheluvamba Hospital, Adichunchanagiri Institute of Medical Sciences, and to know regarding the pattern of presentation, pathological correlation, with type of fibroid, and endometrial and ovarian changes. A clinical study of 100 cases of fibroid uterus was conducted in the Cheluvamba Hospital, attached to Mysore Medical College and Research Institute, Mysore, and Adichunchanagiri Institute of medical sciences, BG Nagara, Mandya from November 2008 to August 2012. The cases are selected by random allocation. On admission, detailed history, clinical examination, and investigations were recorded. Leiomyoma is the most common benign tumor of the uterus and commonly affects the women of child-bearing age, most commonly in the third decade, 55%. The most common mode of presentation was menstrual disturbances (76%), among which menorrhagia was seen in 54% of the cases. Primary infertility was seen in 15% of the patients. Intramural fibroids were the most common variety occurring in 60% of the cases. Endometrial pattern was proliferative in 66.3%. Cystic ovaries were seen in 8% of the patients, adenomyosis in 16% indicating hyperestrogenism. Fibromyoma (leiomyoma) is the most common benign tumor of the pelvis. It commonly affects the women of child-bearing age, mostly in the third decade and is most commonly seen in multipara. The most common mode of presentation is menstrual disturbances. Intramural fibroid is the most common variety. The proliferative and hyperplastic endometrium was commonly reported. The presence of proliferative endometrium, adenomyosis, and cystic ovaries all are indicative of hyperestrogenic state associated with development of fibroids.

Comments on "Uterine Artery Embolization Following Internal Iliac Arteries Ligation in a Case of Postpartum Hemorrhage: A Technical Challenge".

Postpartum hemorrhage (PPH) is defined as a blood loss of more than 500 ml following vaginal delivery and more than 1 l following cesarean section. The definitive procedure for severe PPH is hysterectomy. Due to its high morbidity and impact on fertility, it is undesirable in majority of patients. Fertility preserving procedures include internal iliac artery ligation (IIAL), uterine artery ligation (UAL), and selective uterine artery embolization (UAE). The former two surgical procedures require laparotomy. Moreover, there are high failure rates and morbidity of IIAL. Bilateral UAL has been shown to carry high success rates and relatively low complication rates. UAE is a less invasive technique that has success rates similar to UAL [1]. The advantage of utilisation of UAE early in the management protocol of severe refractory PPH has been well documented. In case of failure, surgical techniques (arterial ligation/hysterectomy) can be undertaken without any hindrance. In contrast, if the surgical ligation procedures are performed without consideration of UAE, the application of latter becomes extremely challenging (as in the present case) should the ligation procedures fail [2]. Thus, there should be low threshold for UAE in the setting of severe refractory PPH. To the best of our knowledge, there are no reports of UAE through the ligated internal iliac artery and as such, our case emphasises that even arterial ligation does not preclude UAE, if the patient continues to worsen.

Clinical analysis on selective uterine artery embolization combined with hysteroscopic surgery for exogenous cesarean scar pregnancy in 67 cases

To investigate the safety and feasibility of uterine arterial embolization (UAE) combined with hystersocpic excisionl of exogenous cesarean scar pregnancy (CSP). Totally 67 patients with exogenous CSP treated with selective UAE combined with hysterscopic surgery in Shengjing Hospital of China Medical University were analyzed retrospectively; 35 patients in Group A (thickness of the cesarean scar > 3 mm), while 32 patients in Group B (thickness of the cesarean scar ≤ 3 mm). The following clinical parameters including operative time, intraoperative blood loss, quantity of postoperative uterine drainage, postoperative hospital days, the time for the mass absorption and the return of β-hCG to normal were compared. All hysterscopic procedures were successfully completed in Group A, and only one case underwent a second hysteroscopic excision due to the 1-month postoperative ultrasound examination indicating a mass located in the cesarean scar and a slow decline of β-hCG. Three cases of Group B were transformed to laparoscopic or laparotomy operation and 7 cases underwent a second surgery. The volume of introperative blood loss was (97 ± 41) ml in Group A and (161 ± 92) ml in Group B, the difference was statistically significant (P < 0.01). But the operative time, quantity of postoperative uterine drainage, postoperative hospital days, the time for the retrun of β-hCG to normal and the mass absorption in Group A were (36 ± 9) minutes, (38 ± 13) ml, (3.5 ± 0.5) days, (26 ± 5) days, (82 ± 17) days, in Group B were (37 ± 9) minutes, (42 ± 16) ml, (4.0 ± 0.7) days, (28 ± 8) days, (88 ± 15) days, respectively, the differences were not statistically significant (all P > 0.05). For exogenous CSP, when the thickness of cesarean scar is ≤ 3 mm, whether or not undertaking UAE, it should be seen as contraindication of hysterscopic surgery. UAE combined with hysterscopic surgery for the treatment of exogeous CSP with the cesarean scar thickness > 3 mm is safe and feasible according to patients condition and should be performed by experienced hysteroscopist.

EMBOLIZACIÓN UTERINA DE EMERGENCIA EN LA HEMORRAGIA MASIVA

OBJETIVO: Evaluar la eficacia y seguridad de la embolización uterina de emergencia en el manejo de la hemorragia masiva en caso de inestabilidad hemodinamica. LUGAR: Servicio de Radiología Intervencionista, Hospital Nacional Guillermo Almenara Irigoyen, Essalud, Lima. MATERIAL Y MÉTODOS: Se realizó embolización uterina en 6 pacientes con hemorragia severa. La media de hemoglobina antes del procedimiento fue 5,2 g/dL. RESULTADOS: Reducción inmediata del sangrado activo. No se observó complicaciones mayores. Se realizó 2 histerectomías en condiciones estables. CONCLUSIONES: La embolización uterina de emergencia s segura y efectiva en controlar la hemorragia masiva. El procedimiento evita una cirugía de emergencia de alto riesgo alto.

Grossesse sur cicatrice de césarienne : traitement combiné avec embolisation des artères utérines avant procédure chirurgicale

ObjectivesTo offer a therapeutic management of cesarean scar pregnancies (GSC) in the first trimester of pregnancy with a first approach by uterine artery embolization (UAE) Patients and methodsThis study describes seven cases of GSC diagnosed between 2009 and 2013 in the clinic of the University Hospital of the Hospital of Croix-Rousse. We present the symptoms and how imagery has led to the diagnosis and the therapeutic management conducted. ResultsThe mean gestational age at diagnosis was 9 weeks gestation. There were ongoing pregnancies with cardiac activity present for each patient. An additional MRI was performed in five patients. Five patients were treated with methotrexate injection, two patients received the Mifegyne. All patients then received a selective uterine artery embolization. Finally within 48hours, suction curettage was performed in 6 patients. A patient at 13 WA+1 required a subtotal hysterectomy for placenta accreta. Intra-operative complications were represented by a bladder injury, two bleeding of 1000mL in patients at 13 WA+1 and 12 WA. For the 6 cases of GSC with a gestational age less than 10 WA, average blood loss was less than 500mL. Three patients underwent resection of scar isthmocele confirmed by EVAC. An intrauterine pregnancy was carried to term after care. Discussion and ConclusionCesarean scar pregnancies is a diagnostic and therapeutic challenge, which should be diagnosed as early as soon as possible with care in a medical facility with a uterine artery embolization technical platform. Our protocol combining Mifegyne and methotrexate for termination of pregnancy and uterine artery embolization (UAE) followed by curettage for evacuation of pregnancy allows conservative treatment while minimizing the risk of bleeding (for GSC diagnosed before 10 WA).

Uterine artery embolisation as management of postoperative gynaecological haemorrhage.

Uterine artery embolisation is already known as a simple, effective procedure for management of a wide variety of obstetric [1] and gynaecological [2] haemorrhages. Embolisation aims to achieve immediate and effective control of haemorrhaging. In what follows we shall report a clinical case dealt with at the Albacete General University Hospital, where embolisation was performed in order to manage bleeding in the early gynaecological postoperative period. The patient has given informed consent for publication of this research. The case concerns a 44-year-old woman with menorrhagia and intramural myoma of 82 × 69 mm. In December 2012 simple vaginal hysterectomy was carried out on the patient. No complications arose during surgery, but in the immediate postoperative period the patient suffered heavy vaginal bleeding and needed a blood transfusion due to symptomatic anaemia (Hb: 7.1 g/dl, Hto: 19%). The patient being young and haemodynamically stable, it was decided to perform uterine artery embolisation 24 h after surgery; we chose such a conservative measure in order to avoid laparotomy. The patient was informed of all advantages and disadvantages of this technique and agreed to its use. In our hospital there is a round-the-clock, long-experienced Interventional Radiology Service with enough human and material resources. Uterine artery embolisation was carried out using Seldinger's technique. First of all, access was obtained to the left hypogastric artery, where an area of hypervascularisation associated with the cranial uterine artery going to the urinary bladder was found. Therefore, embolisation with 3 mm coils was performed. Accessing the right hypogastric region afterwards, an image similar to the one in the left region was seen, leading to an additional embolisation (Figure 1). In Figure 2 embolisation of the right uterine artery with coils can be observed. A control arteriography subsequently confirmed cessation of vascular leakage (Figure 3). The technique was performed without complications, causing an immediate end of the patient's vaginal bleeding. Her evolution was favourable, and she remained totally asymptomatic. Figure 1 Arteriography of the right hypogastric artery, visualising the vanishing point Figure 2 Catheterisation of the right uterine artery and subsequent embolisation with coils Figure 3 Control arteriography confirming cessation of vascular leakage The aim of this paper is to suggest that selective embolisation of uterine arteries is a technique to be taken into account in the management of haemorrhages arising in the immediate postoperative period of gynaecological surgery. In the literature there are many research papers describing embolisations done in order to manage obstetrical haemorrhages [3]. But published data on the embolisation of haemorrhages that arise in the immediate postoperative period following gynaecological surgery are limited [4, 5]. It is generally believed that the same techniques and general principles of embolisation are also applicable in such cases. However, this technique is not free of complications. Complications such as transient fever, transient buttock ischemia, lower limb paraesthesia, groin haematoma and pelvic abscess or vesicovaginal fistula formation have been reported. But these situations are exceptional; the benefits of embolisation are greater than the disadvantages [4]. Embolisation is more complex to perform in gynaecological than in obstetrical haemorrhages. This is due to the fact that patients who have undergone surgery, radiotherapy or even both are distorted, as well as their normal anatomic relationships, which renders the existence of atypical sources of vascular replacement for the bleeding point perfectly possible. That is why gynaecological embolisation, in order to be effective, sometimes needs to be more extensive than what is usually the case for obstetrical embolisation [2]. To conclude, selective uterine artery embolisation can be described as a simple, minimally invasive technique that should be taken into account in the management of gynaecological postoperative bleeding. It could play an important role in complex patients, since it achieves good haemorrhage control without need of further surgical intervention.

Successful Management of a Scary Case of Cesarean Scar Pregnancy with Combined Treatment using Methotrexate, Uterine Artery Embolization and Suction Evacuation

ABSTRACT Cesarean scar pregnancy (CSP) is the rarest type of ectopic pregnancy implanted in the myometrium at the site of the previous cesarean section scar. It may lead catastrophic complications like uterine rupture and uncontrollable hemorrhage.4 Early diagnosis can offer treatment options of avoiding uterine rupture and hemorrhage, thus, preserving the uterus and future fertility. The conservative treatment can be by local and/or systemic administration of methotrexate, dilatation and curettage, excision of trophoblastic tissues (laparoscopy/laparotomy), bilateral internal artery ligation with trophoblastic evacuation and uterine artery embolization7 combined with curettage and/ or methotrexate. We did successful treatment of a viable CSP by systemic injections of methotrexate followed by selective uterine artery embolization in combination with dilatation and curettage. How to cite this article Mehta P, Vishwanath U, Joseph S, Anitha M. Successful Management of a Scary Case of Cesarean Scar Pregnancy with Combined Treatment using Methotrexate, Uterine Artery Embolization and Suction Evacuation. J South Asian Feder Obst Gynae 2015;7(3):143-147.

Uterine Artery Embolization Following Internal Iliac Arteries Ligation in a Case of Post-Partum Hemorrhage: A Technical Challenge.

Postpartum hemorrhage (PPH) is defined as a blood loss of more than 500 ml following vaginal delivery and more than 1 l following cesarean section. The definitive procedure for severe PPH is hysterectomy. Due to its high morbidity and impact on fertility, it is undesirable in majority of patients. Fertility preserving procedures include internal iliac artery ligation (IIAL), uterine artery ligation (UAL), and selective uterine artery embolization (UAE). The former two surgical procedures require laparotomy. Moreover, there are high failure rates and morbidity of IIAL. Bilateral UAL has been shown to carry high success rates and relatively low complication rates. UAE is a less invasive technique that has success rates similar to UAL [1]. The advantage of utilisation of UAE early in the management protocol of severe refractory PPH has been well documented. In case of failure, surgical techniques (arterial ligation/hysterectomy) can be undertaken without any hindrance. In contrast, if the surgical ligation procedures are performed without consideration of UAE, the application of latter becomes extremely challenging (as in the present case) should the ligation procedures fail [2]. Thus, there should be low threshold for UAE in the setting of severe refractory PPH. To the best of our knowledge, there are no reports of UAE through the ligated internal iliac artery and as such, our case emphasises that even arterial ligation does not preclude UAE, if the patient continues to worsen.

Uterine Artery Pseudoaneurysm Requiring Embolization During Pregnancy

Uterine artery pseudoaneurysm has a pathognomonic ultrasound appearance. Its occurrence in pregnancy is life-threatening for both mother and fetus. We present an illustrative case and discuss management with selective uterine artery embolization during pregnancy. A 37-year-old pregnant woman presented with profuse painless vaginal blood loss at a gestational age of 27 weeks. Ultrasonography and magnetic resonance imaging indicated a left-sided uterine artery pseudoaneurysm. Selective embolization of the pseudoaneurysm was performed. Blood loss ceased allowing the pregnancy to continue until term. Endovascular embolization is a feasible therapeutic option for a uterine artery pseudoaneurysm during pregnancy without compromising fetoplacental perfusion.

Role of interventional radiology in treating obstetric haemorrhages

The aim of this study was to evaluate the efficacy and the safety of selective uterine artery embolisation in patients with a high risk of haemorrhage due to obstetric issues. We retrospectively reviewed the angiographic examinations of 63 patients (average age ± SD, 32.6 years ± 4.8), affected by an obstetric disease with a high risk of haemorrhage (22 cases of ectopic pregnancy, 41 of postpartum haemorrhage) and treated with an interventional approach. In particular, we considered the rate of second treatment with interventional technique or conservative or radical surgery, the incidence of postprocedural complications, and the absorbed radiation dose. Immediate technical success, defined as the cessation of active bleeding, was achieved in all cases. Uterine artery embolisation was able alone to control the haemorrhage in 95.24 % of cases. Three patients required a second treatment to achieve haemostasis. No peri- or postprocedural complications were observed. At the 12-month follow-up after embolisation, 22/49 conservatively treated patients were found to be pregnant and successfully completed their pregnancy. Selective uterine artery embolisation allows for safe and complete control of haemorrhage in patients with obstetric disease, with a very low incidence of complications and preservation of fertility.

Shortened Cervix in the Subsequent Pregnancy after Embolization for Postpartum Cervical Hemorrhage

Introduction. Rupture of a branch of uterine artery during delivery often leads to a massive postpartum hemorrhage that can be successfully treated using uterine artery embolization. Case Report. A 33-year-old woman had a cesarean section at term followed by a secondary postpartum hemorrhage due to a ruptured cervicovaginal branch terminating in a large, partially thrombosed hematoma of the cervix. She was given selective uterine artery embolization, and she was discharged to home in stable condition on the third day after embolization. In the forthcoming pregnancy a shortened cervix was a risk of threatened premature delivery from 26 weeks of gestation onwards. Conclusion. Superselective unilateral embolization of a thrombosed hematoma in the cervix might prevent extensive iatrogenic trauma of the cervix, which allows preservation of reproductive function.

Uterine artery embolization in residual arterio-venous fistula due to invasive mole using glue and polyvinyl alcohol particles: Case report

Gestational trophoblastic diseases (GTD) are one of the rare complications of pregnancy, which include partial and complete moles with their more aggressive counterparts termed as Gestational trophoblastic neoplasias (GTN). Their association with uterine vascular malformations is well recognised and should be suspected in appropriate clinical settings. Selective uterine artery embolization is a safe and effective alternative method of treatment in a patient with severe per vaginal bleeding from residual uterine vascular malformations due to GTN which has relative lower morbidity and mortality than surgical procedures. Here, we report a case of residual uterine arterio-venous malformation due to invasive mole detected by ultrasonography (US) and contrast enhancedMRI & referred to Interventional Radiology for Transcathetor arterial embolization.

Successful Uterine Artery Embolization for Intractable Postpartum Hemorrhage Using a Novel Embolic Agent: ONYX

Abstract Background: Primary postpartum hemorrhage (PPH) remains one of the main causes of maternal morbidity and mortality worldwide. Selective bilateral uterine artery embolization has been used since the 1970s for the conservative treatment of PPH. Case: A gravida 10, para 0, 41-year-old woman with twins of 35-weeks' gestation admitted for vaginal bleeding was diagnosed for placenta accreta by ultrasound (US) and magnetic resonance imaging (MRI). Delivery was performed by cesarean section. Preoperatively, the complications and risks associated with this potential diagnosis, including hysterectomy, were discussed with the patient. Bearing in mind the patient's desire to preserve her uterus, the placenta accreta was partially removed. However, because of severe bleeding and hemodynamic instability, the patient was referred to the vascular interventional radiology unit for intraoperative transcatheter arterial embolization (TAE). As standard procedures had failed to achieve full hemostasis, a new embolic ...

Conservative management of placenta increta treated with selective uterine artery embolization: Review of two cases

Placenta increta is a condition characterized by abnormal adherence of the placenta owing to entire or partial absence of the decidua basalis. It is generally recognized during difficult placental removal at the time of delivery. It is a life-threatening complication of pregnancy due to massive hemorrhage, uterine perforation, and infection and thus often a hysterectomy is required. We review two cases of placenta increta conservative managed successfully by selective uterine artery embolization.

Uterine artery pseudoaneurysm as a cause of secondary postpartum haemorrhage following a caesarean section

Postpartum haemorrhage (PPH) is a major direct cause of maternal mortality worldwide, and primary PPH accounts for most of these deaths. Secondary PPH is not usually as catastrophic and certainly less frequent but may still cause significant morbidity, and if not appropriately managed, can also lead to maternal death. The common causes of secondary PPH include subinvolution of the placental site, retained products of conception and endometritis. Rare causes such as uterine or cervical neoplasms as well as vascular abnormalities including uterine artery pseudoaneurysm, should be excluded, especially in patients not responding to uterotonics and antibiotics. Traditionally the treatment of uterine artery pseudoaneurysms would warrant a surgical approach, but recently selective uterine artery embolization (UAE) has become the treatment of choice. Ultrasound-guided thrombin injection of these vascular anomalies has also been successfully used in appropriate cases. With the availability of these uterine-preserving techniques, clinicians should perhaps consider UAE in the haemodynamically stable patient before resorting to surgery.

Uterine necrosis associated with acute suppurative myometritis after angiographic selective embolization for refractory postpartum hemorrhage

We report a case of a woman in whom uterine arterial embolization was performed using absorbable gelfoam particles for control of refractory postpartum hemorrhage. Ten days after delivery, the woman experienced high fever and low abdominal pain. Histologic findings after hysterectomy were consistent with uterine necrosis and acute suppurative myometritis.

Embarazo ectópico cervical: a propósito de 3 casos. Revisión de la práctica clínica

Three cases of cervical ectopic pregnancy treated medically are described. The first case with selective uterine artery embolization and methotrexate dose single, the second case with selective uterine artery embolization and methotrexate dose multiple, and the third case intraamniotic puncture and instillation of KCl due to persistent embryonic heartbeat was necesary, before selective uterine artery and methotrexate dose unique. A spontaneous evacuation of the cervical pregnancy occurred in all patients treated conservatively. We postulate that the preventive use of uterine artery embolization in combination with standard MTX treatment could contribute to reduce the risk of excessive bleeding and facilitate spontaneous expulsion. The diagnostic and therapeutic methods are discussed and the literature is reviewed.

Transcatheter Intraarterial Methotrexate Infusion Combined with Selective Uterine Artery Embolization as a Treatment Option for Cervical Pregnancy

To assess the value of transcatheter intraarterial methotrexate infusion combined with selective uterine artery embolization (UAE) as a treatment option for cervical pregnancy. Between January 2004 and June 2009, a prospective study was conducted in 20 consecutive patients with cervical pregnancy. The patients were treated with UAE with gelatin sponge particles (1-2 mm in size) to control active vaginal bleeding. Methotrexate was injected into the arteries before, during, and after UAE. Two of 20 patients (10%) had recurrent vaginal bleeding of approximately 50 mL daily after treatment; the other 18 (90%) had no significant vaginal bleeding after UAE. Fifteen cases (75%) were treated successfully by a single procedure and five (25%) required a subsequent curettage without blood transfusion. The degeneration of placenta was confirmed by light microscopy after curettage. The cervical gestational sac was eliminated at a mean of 41 days (range, 11-83 d). Increased serum beta-human chorionic gonadotrophin levels normalized by an average of 30 days (range, 7-49 d). The uterus was preserved and normal menses resumed within 2-4 months in all 20 women (100%). Of 16 women who attempted another pregnancy, eight (50%) achieved pregnancy: there were six term pregnancies with live births (38%) and two miscarriages (13%). No obvious complications related to treatment occurred, but a few mild side effects were observed in nine cases (45%). Based on this series of 20 patients, the conservative protocol of transcatheter intraarterial methotrexate infusion combined with UAE may be a feasible, effective, and safe option for cervical pregnancy.

Vascular malformations in relation to obstetrics and gynaecology: diagnosis and treatment

Key content Acquired uterine artery and congenital uterine arteriovenous malformations are rare but are associated with intractable uterine haemorrhage and increased maternal morbidity and mortality if not diagnosed early. A high index of suspicion is required to make a timely diagnosis. Haemorrhages resulting from acquired uterine artery and congenital uterine arteriovenous malformations are associated with a previous history of obstetric or gynaecological surgery. Ultrasound can be key in diagnosing and localising these lesions before angiography. Selective uterine artery embolisation is the treatment of choice. Learning objectives To understand how uterine artery malformations are acquired and potential methods of prevention. To recognise the clinical presentations of these lesions. To note the role of ultrasound and colour Doppler examination in their diagnosis. To identify appropriate management strategies. Ethical issues Early diagnosis prevents unnecessary intervention such as evacuation of retained products of conception and use of antibiotics in cases of postpartum haemorrhage, or even hysterectomy. Selective uterine artery embolisation appears to preserve ovarian function. Please cite this article as: Abu‐Ghazza O, Hayes K, Chandraharan E, Belli AM. Vascular malformations in relation to obstetrics and gynaecology: diagnosis and treatment. The Obstetrician &amp; Gynaecologist 2010;12:87–93.

Effect of selective uterine artery embolization on symptomatic uterine fibroids

Objective To evaluate the outcomes of selective uterine artery embolization (SUAE) in treatment of symptomatic uterine fibroids using Color Doppler ultrasonography (CDUS). Methods As the procedure SUAE for fibroids, prospective data of the initial 65 consecutive women treated from March 2007 to September 2009 were collected. The follow-up period from 1 week to 30 months, using questionnaires, we investigated the fibroid-related physical and psychological symptoms, and the cumulative rates of symptom control, gynecologic interventions, and complications. The volumes of uterine and uterine fibroids were calculated by CDUS pre- and post-SUAE for 6 months. And we tested the levels of internal hormone including FSH, LH and E2 before and after SUAE for 3, 6 months. Results SUAE was performed successfully in all patients. There was no peri-operative morbidity in all procedures. Compared with pre-SUAE volumes of uterine [(322±112) cm 3] and uterine fibroids [(125±46) cm 3], their volumes in post-SUAE were (144±72) cm 3 and (51±11) cm 3 ( P<0.01), and reduction rate was 58% and 61%, respectively. At 3, 6 months after SUAE, levels of FSH, LH, and E2 were not decreased than that of in pre-SUAE ( P>0.05). After SUAE for 24 months, the fibroids related physical and psychological symptoms such as bleeding, pain and quality of life were significantly improved ( P<0.01). 90.8% (59/65) women had resolution of symptoms and no significant post-procedural symptoms. Parts of patients discharge necrotic fibroids. 86% (34/40) complications were minor, requiring no therapy. 9.2% (6/65) had significant post-procedural symptoms, requiring therapy in hospital or out-patient department. Conclusion SUAE contributes to a long-term significant improvement of all investigated uterine fibroid-related symptoms and markedly improves women's health-related quality of life. SUAE that no impair on changes of internal hormone, under suitable conditions, represents an attractive alternative to hysterectomy for the treatment of symptomatic fibroids and is a minimally invasive, new method of good clinical prognosis. CDUS is an effective to investigate the outcome of SUAE.