Symptomatic Fibroids Research Articles

Updates on the Surgical Approach to Fibroids: The Importance of Radiofrequency Ablation.

Uterine fibroids are the most common benign neoplasm of the female pelvis and have a lifetime prevalence exceeding 80% among African American women and approaching 70% among Caucasian women. Approximately 50% of women with fibroids experience symptoms which can range from heavy menstrual bleeding and bulk-related symptoms such as pelvic pressure with bladder and bowel dysfunction to reproductive dysfunction (e.g., infertility or obstetric complications) and pain. The choice of treatment is primarily guided by the type of symptoms in the individual patient and whether they prefer to retain fertility. While hysterectomy provides definitive resolution of fibroid symptoms and remains the most common treatment option, this procedure is invasive with a long recovery window. Radiofrequency ablation (RFA) is now emerging as a uterine preserving and minimally invasive therapy for symptomatic fibroids. Since its introduction, growing evidence for safety and efficacy of RFA has been generated with low rates of complications. This review will discuss RFA for the management of symptomatic uterine fibroids with a special focus on technical approaches, short- and long-term outcomes including fertility outcomes.

ULIPRISTAL ACETATE VERSUS PLACEBO FOR FIBROID TREATMENT

Background: The efficacy and safety of oral ulipristal acetate for the treatment of symptomatic uterine fibroids before surgery are uncertain. Methods: We randomly assigned women with symptomatic fibroids, excessive uterine bleeding (a score of >100 on the pictorial blood-loss assessment chart [PBAC, an objective assessment of blood loss, in which monthly scores range from 0 to >500, with higher numbers indicating more bleeding]) and anemia (hemoglobin level of ≤10.2 g per deciliter) to receive treatment for up to 13 weeks with oral ulipristal acetate at a dose of 5 mg per day (96 women) or 10 mg per day (98 women) or to receive placebo (48 women). All patients received iron supplementation. The coprimary efficacy end points were control of uterine bleeding (PBAC score of <75) and reduction of fibroid volume at week 13, after which patients could undergo surgery. Results: At 13 weeks, uterine bleeding was controlled in 91% of the women receiving 5 mg of ulipristal acetate, and 19% of those receiving placebo (P<0.001 for the comparison of each dose of ulipristal acetate with placebo). The rates of amenorrhea were 73%, and 6%, respectively, with amenorrhea occurring within 10 days in the majority of patients receiving ulipristal acetate. The median changes in total fibroid volume were −21%,, and +3% (P = 0.002 for the comparison of 5 mg of ulipristal acetate with placebo. Serious adverse events occurred in one patient during treatment with 5 mg of ulipristal acetate (uterine hemorrhage) and in one patient during receipt of placebo (fibroid protruding through the cervix). Headache and breast tenderness were the most common adverse events associated with ulipristal acetate but did not occur significantly more frequently than with placebo. Conclusions: Treatment with ulipristal acetate for 13 weeks effectively controlled excessive bleeding due to uterine fibroids and reduced the size of the fibroids.

ULIPRISTAL ACETATE VERSUS PLACEBO FOR FIBROID TREATMENT

Background: The efficacy and safety of oral ulipristal acetate for the treatment of symptomatic uterine fibroids before surgery are uncertain. Methods: We randomly assigned women with symptomatic fibroids, excessive uterine bleeding (a score of >100 on the pictorial blood-loss assessment chart [PBAC, an objective assessment of blood loss, in which monthly scores range from 0 to >500, with higher numbers indicating more bleeding]) and anemia (hemoglobin level of ≤10.2 g per deciliter) to receive treatment for up to 13 weeks with oral ulipristal acetate at a dose of 5 mg per day (96 women) or 10 mg per day (98 women) or to receive placebo (48 women). All patients received iron supplementation. The coprimary efficacy end points were control of uterine bleeding (PBAC score of <75) and reduction of fibroid volume at week 13, after which patients could undergo surgery. Results: At 13 weeks, uterine bleeding was controlled in 91% of the women receiving 5 mg of ulipristal acetate, and 19% of those receiving placebo (P<0.001 for the comparison of each dose of ulipristal acetate with placebo). The rates of amenorrhea were 73%, and 6%, respectively, with amenorrhea occurring within 10 days in the majority of patients receiving ulipristal acetate. The median changes in total fibroid volume were −21%,, and +3% (P = 0.002 for the comparison of 5 mg of ulipristal acetate with placebo. Serious adverse events occurred in one patient during treatment with 5 mg of ulipristal acetate (uterine hemorrhage) and in one patient during receipt of placebo (fibroid protruding through the cervix). Headache and breast tenderness were the most common adverse events associated with ulipristal acetate but did not occur significantly more frequently than with placebo. Conclusions: Treatment with ulipristal acetate for 13 weeks effectively controlled excessive bleeding due to uterine fibroids and reduced the size of the fibroids.

Medical historical notes on myoma treatment by uterine artery embolization on the occasion of its introduction 30 years ago.

Since its development, uterine artery embolization (UAE) for the treatment of symptomatic fibroids has become an established minimally invasive alternative to surgical myoma treatment. Currently, more than 25,000 myoma patients worldwide are likely to be treated with UAE annually. Thirty years ago, Jacques-Henri Ravina (b. 1930) and his Paris team first performed this therapy as a "substitute" for gynecologic surgery. We contacted him as part of the preparation of the present review. In addition, we performed a literature search with the aim of summarizing the current literature and data in addition to a historical account of the development of UAE. On the occasion of this anniversary, we would like to recall the interdisciplinary roots and some facets of the history of the development of this relatively young myoma treatment method. · UAE is an established minimally invasive alternative to surgical myoma treatment.. · UAE was first developed 30 years ago.. · UAE has continuously increased in importance in recent years.. · Psilopatis I, Fleckenstein FN, Gebauer B et al. Medical historical notes on myoma treatment by uterine artery embolization on the occasion of its introduction 30 years ago. Fortschr Röntgenstr 2023; DOI: 10.1055/a-2077-1387.

Accuracy of Gravimetric Method of Blood Loss Estimation during Open Myomectomy

Background: Estimation of blood loss during surgery is a critical component that may affect patients’ management. Objective: The study evaluated the accuracy of the gravimetric method of blood loss estimation in women with an open myomectomy. Materials and Methods: This was a cross-sectional analytical study that evaluated the accuracy of the gravimetric method of measuring blood loss during open myomectomy for patients with symptomatic fibroid at a Teaching Hospital in Nigeria. The diagnosis of uterine fibroids was based on clinical examination and ultrasound scan. A proforma was used to record information from those who gave written consent. The gravimetric method and visual estimation were compared with the actual blood loss (ABL) as the gold standard. Statistical analysis was done using Stata version 16. Student's t-test was used to compare the mean blood loss estimation of the different methods. The significant level was set at P-value <0.05. Results: A total of 78 women who had open myomectomy participated in the study. The mean ABL was 787.11 ± 63.17 mL. The mean blood loss by the gravimetric method was 755.95 ± 492.72 mL, while the mean estimation error by the gravimetric method was 31.16 ± 263.23 mL. The mean difference between the estimated ABL and the loss estimated by the gravimetric method was 31.18 mL. This was not statistically significant (P-value = 0.30). However, there was a statistically significant difference between the ABL and blood loss by visual method (mean difference = 161.64, P-value = 0.02). Conclusion: The gravimetric estimation of blood loss during surgery correlated with actual estimated blood loss. It should be considered in the routine estimation of blood loss during surgery.

Pathologic Profile of Hysterectomy Cases in Saudi Arabia: A Tertiary Center Experience.

Hysterectomies are increasingly being replaced by more conservative management modalities and are now only used for limited clinical indications. The agreement between these indications and the final pathology is understudied. This study aimed to correlate the preoperative clinical diagnoses with the pathological findings detected in hysterectomies in Saudi women of different age groups. This retrospective study analyzed the preoperative clinical indications and the subsequent clinical and pathological data of all hysterectomies conducted at a single tertiary care hospital in the Eastern Province of Saudi Arabia between January 2010 and December 2021. There was no decline in the frequency of hysterectomies across the study period. Abnormal uterine bleeding was the most common clinical indication across all age groups, followed by symptomatic fibroid and uterine prolapse in women aged <50 and ≥50 years, respectively. A total of 9.2% of the cases were indicated for therapeutic reasons, either as an emergency procedure for peripartum hemorrhage or for suspected uterine premalignant and malignant lesions. Besides these, 41.2% of patients had more than one pathology, with the most common combination being leiomyoma and adenomyosis (43.4%). The difference in age between malignant and benign cases (52.3 vs. 48.8 years, respectively) was not statistically significant (P = 0.109). Most of our cohort had benign lesions. Perceptible misuse of the procedure in this cohort was unlikely, as a large proportion of the patients had more than one pathology corresponding to each clinical indication.

Uterine Artery Embolization for the Treatment of Symptomatic Uterine Fibroids of Different Sizes: A Single Center Experience.

The present study aimed to evaluate the clinical and radiological 1-year outcomes of uterine artery embolization (UAE) performed in a selected population of women with symptomatic myomas and who do not wish to conceive. Between January 2004 and January 2018, a total of 62 patients with pre-menopausal status and with no wish to conceive in the future underwent UAE for the treatment of symptomatic fibroids. All the patients underwent magnetic resonance imaging (MRI) and/or transvaginal ultrasonography (TV-US) before and after the procedure at 1-year follow-up. Clinical and radiological parameters were recorded, stratifying the population into 3 groups according to the size of the dominant myoma (group 1: <50 mm; group 2: ≥50 and ≤80 mm; group 3: >80 mm). Mean fibroid diameter was significantly reduced (42.6% ± 21.6%) at 1-year follow-up, with excellent improvements in terms of both symptoms and quality of life. No significant difference was observed regarding baseline dimension and the number of myomas. No major complications were reported (2.5%). The present study confirms the safety and efficacy of UAE in the treatment of symptomatic fibroids in pre-menopausal women with no desire to conceive.

Hysteroscopic laser ablation of symptomatic uterine fibroids: insights from a prospective study

Objective This study aimed to evaluate the feasibility and efficacy of in-office hysteroscopic ablation of submucous uterine fibroids using a diode laser. Method A pilot study was conducted between January 2018 and January 2019 in a tertiary care university hospital. Patients with at least one symptomatic, class 0–2 FIGO classification, uterine fibroid ≤7 cm in size were eligible for inclusion. Evaluation of the changes in fibroid size and vascularity was performed using three-dimensional Doppler ultrasonography. Vaporization of the fibroid core was conducted using a 980–1470 nm wavelength diode laser inserted through the hysteroscope’s working channel. The primary outcome was evaluation of the fibroid volume before and at 2 months after the procedure. Results Twenty women were enrolled in the study. At 2-month follow-up, the volume of the fibroids was significantly reduced (51.6 ± 22.5 vs. 33.4 ± 17.1 mm3; p < 0.001). A major reduction of three-dimensional sonographic color Doppler vascularity (observed by the same operator and confirmed by four blind reviewers) was also achieved in 12/20 patients (60%; p = 0.03) while a reported symptom of heavy menstrual bleeding decreased from 18/20 (90%) to 2/18 (10%; p < 0.01). Conclusion Hysteroscopic laser ablation represents a feasible and effective alternative for treating women with symptomatic submucous fibroids in the office setting. Further studies with larger sample size and longer follow-up periods are needed to validate this promising technique. Key message This pilot study shows that in-office hysteroscopic laser ablation (HLA) could be a feasible alternative to treat symptomatic submucous uterine fibroids by coagulating their core, reducing their size and vascularization.

A Case Report of Laparotomic Myomectomy After The Use of Gnrh Analogue in A Brazilian Woman

Uterine leiomyoma is the most common genital benign tumor in the female population. It is estimated that about 20 to 40% of women will have leiomyoma during their reproductive stage. IBGE (Brazilian Institute of Geography and Statistics) estimated the Brazilian population to be over 200 million Brazilians, of which half are women and approximately 50% are of reproductive age; hence, by calculating the prevalence of leiomyomatosis, there would be just over 6 million women with symptomatic fibroids in Brazil that require clinical or surgical treatment.[1-3-4] Due to its presence during the reproductive period, it can be caused by infertility or recurrent spontaneous pregnancy loss. Hence, myomectomy can be necessary when the fibroid itself causes distortion of the endometrial cavity, or competes with the embryo for the same place, or when conservative treatment was ineffective. This report describes a case of myomectomy which was performed after treatment with goserelin acetate with considerable reduction of fibroids volume, probably facilitating surgical approach, decreasing the blood loss and the risk of hysterectomy conversion. In addition, other GnRH analogue benefits before surgery such as doctor’s impression of decrease in size and better mobility of the tumor and patients feeling of decrease of the abdominal volume and the bleeding. This subjective approach can optimize the timing of surgery and establish the number of injections.

Frequency of Diseases Requiring Hysterectomy: A Cross Sectional Study at Tertiary Care Hospitals in Peshawar

Hysterectomy, after cesarean section is the most common performed major surgical procedures all over the world. In the united states, 5.5/1000 women underwent hysterectomy in the years 2001 to 2005. Objective: To estimate the frequencies of different diseases that needs hysterectomy at Peshawar Medical College and its affiliate hospitals. Methods: This cross-sectional study was carried out from 3rd Oct, 2020 to 3rd Oct, 2021 at the Department of Obstetrics and Gynecology, Peshawar Medical College and its affiliated hospitals. Consecutive sampling was done and a sample size of 104 patients was obtained. Those patients who recently underwent abdominal or vaginal hysterectomies aged 25-60 years with history of any parity were included. Patients with co-morbid conditions such ischemic heart disease, chronic kidney disease, malignancies and other obstetric complications such as emergency cesarean hysterectomies were excluded. Results: Mean age with standard deviation was 48.55 ± 8.53. Mean and standard deviation for weight was 73.20 ± 6.103. Of total patients, 44 (42.3%) patients had symptomatic fibroid uterus, 29 (27.9%) patients had uterovaginal prolapse while 31 (29.8%) patients had abnormal uterine bleeding as indication for hysterectomy. Among these patients, 66 (63.5%) were subjected to abdominal hysterectomy while 38 (36.5%) went through vaginal hysterectomy. Conclusions: The most common disease that needs hysterectomy in our study was symptomatic leiomyomas of uterus followed by abnormal uterine bleeding due to other causes and uterovaginal prolapse.

Uterine Artery Embolization for Symptomatic Fibroids Uterus in Gaza

Background: To evaluate interventional success, clinical success and reduction of fibroid diameter after uterine artery embolization (UAE) for patients with symptomatic fibroid uterus in Gaza. Methods: Retrospective study of thirty -two women with symptomatic uterine underwent uterine magnetic resonance imaging (MRI) before and 6 months after UAE. Primary outcome: clinical success is the improvement of the patients presenting symptoms, such as menorrhagia or pain without additional therapy. Secondary outcome: interventional success is a complete occlusion in both uterine arteries and reduction measures of fibroid diameter after 6 months after embolization. Results: Of 32 patients with mean age 44±7.6 years and follow-up between 6-70 months, 30 (93.7%) patients completed follow-up, 1 (3 %) patient had a second procedure and 2 (6 %) were lost to follow-up. Primary outcome: the improvement of symptoms, such as menorrhagia or bulk-related pain without additional therapy was seen in 29 (90%) patients. one patient underwent surgery hysterectomy on 14 months after UAE related complaints and failure of conservative treatment and 2 patients still received therapy to control symptoms. interventional success is a complete occlusion in both uterine arteries was seen in 31 (97%) patients. The mean dominant fibroid diameter reduced from 6.2 ± 2.4 cm to 1.7± 1.44 cm (p = 0.001). Conclusions: Uterine artery embolization significant improvements in fibroid uterus symptoms and long -term follow-ups with low complication rates and very good clinical efficacy

Uterine Artery Embolization for Symptomatic Fibroids Uterus in Gaza

Uterine Artery Embolization for Symptomatic Fibroids Uterus in Gaza

Use of Non-Contrast-Enhanced MR Angiography to Assess Recanalization after Uterine Artery Embolization

The purpose of this study was to examine the use of non-contrast-enhanced MR angiography (MRA) for assessing recanalization of uterine arteries (UAs) after uterine artery embolization (UAE) for symptomatic fibroids. Pre-procedural and follow-up unenhanced MRA images of 30 patients were reviewed, and the extent to which the UAs could be visualized was classified on a 4-point scale. An increase in the score between consecutive time points indicates that a previously inconspicuous segment of the UA became visible on follow-up images. Patients were divided into two groups according to the presence (or absence) of recanalization. The median UA visualization score at each follow-up was significantly lower than that at baseline (p < 0.01), but there was no significant difference between the scores of the follow-up images. Recanalization was detected in 63% (19/30) of patients. In these patients, the mean decrease in uterine and largest fibroid volume at 12 months after UAE was inferior to the mean decrease in patients for whom recanalization was not detected. Based on MRA assessment, recanalization after UAE occurred in 63% of patients but did not compromise the reduction in uterine and dominant fibroid volumes within 12 months after UAE.

A significant burden: A qualitative exploration of the experience of women living with fibroids in St. Kitts and Nevis

Background: Our study aimed to understand the illness experience of women living in St Kitts and Nevis who have been affected by fibroids by utilising Leventhal’s commonsense model of illness. Methods: Upon receiving ethics approval, females aged between 18 and 55 who were currently a resident in St Kitts and Nevis and who had an experience with fibroids within the last 5 years were recruited to consent and complete 1-hour interviews during which they described the different ways in which fibroids affects them. Results: The interview guide incorporated the common-sense model; all interviews were 1:1 and a thematic analysis was conducted. The final sample consisted of 11 women, 10 from St Kitts and 1 from Nevis. Their ages ranged from 23 to 49, and the average age of participants was 39 years. Participants described their fibroids in generally negative terms and noted several physical, emotional, social and professional consequences as a result of their fibroid symptoms. Conclusions: Our study revealed the need for a clear strategy for managing patients with symptomatic fibroids—a strategy that includes regular monitoring of patients, good communication between doctor and patient and clear guidance on management for patients.

Abstract No. 145 Resorbable Gelatin Microspheres versus Tris-Acryl Microspheres: Randomized Controlled Trial Comparing Pain, Inflammatory Response and Embolic Effect after Uterine Artery Embolization for Symptomatic Fibroids

Abstract No. 145 Resorbable Gelatin Microspheres versus Tris-Acryl Microspheres: Randomized Controlled Trial Comparing Pain, Inflammatory Response and Embolic Effect after Uterine Artery Embolization for Symptomatic Fibroids

Asherman Syndrome after Uterine Artery Embolization: A Cohort Study about Surgery Management and Fertility Outcomes

To study severity of intrauterine adhesions after uterine arterial embolization and to evaluate fertility, pregnancy and obstetrical outcomes after hysteroscopic treatment. Retrospective Cohort SETTING: French University Hospital PATIENTS: Thirty-three patients under the age of 40 years who were treated by uterine artery embolization with non-absorbable microparticles between 2010 and 2020 for symptomatic fibroids or adenomyosis or postpartum hemorrhage. All patients had a diagnosis of intrauterine adhesions after embolization. All patients desired future fertility. Intrauterine adhesions was treat with operative hysteroscopy. Severity of intrauterine adhesions, number of operative hysteroscopies performed to obtain a normal cavity shape, pregnancy rate, obstetrical outcomes. On our 33 patients, 81.8% had severe intrauterine adhesions (state IV et V according to the European Society of Gynecological Endoscopy or state III according to the American fertility society classification). To restore fertility potential, an average of 3.4 operative hysteroscopies had to be performed [IC 95% (2.56 - 4.16)]. We reported a very low rate of pregnancy (8/33, 24%). Obstetrical outcomes reported are 50% of premature birth and 62,5% of delivery hemorrhage partly due to 37,5% of placenta accreta. We reported also 2 neonatal deaths. Intrauterine adhesions after uterine embolization are severe, more difficult to treat than others synechiae, probably related to endometrial necrosis. Pregnancy and obstetrical outcomes have shown a low pregnancy rate, an increased risk of preterm delivery, a high risk of placental disorders and very severe post-partum hemorrhage. Those results have to alert gynecologists and radiologists to the use of UAE in women who desired future fertility.

Effects of long-term intermittent pharmacological therapy with ulipristal acetate on reducing the volume of uterine fibroids and relieving symptoms.

The aim of this study was to compare the effects of a 12-week course and four repeated 12-week courses of daily 5 mg ulipristal acetate (UPA) on reducing the volume and relieving symptoms of uterine fibroids. From 2016 to 2019, 287 female patients with uterine fibroids diagnosed using ultrasonography were recruited. The patients received four 12-week course treatments of daily UPA administration in the first and fourth sessions, respectively. During the first and fourth courses of UPA, we measured the volume of the fibroids using ultrasonography to study the effect on volume reduction. The measured outcomes included symptomatic relief and adverse effects. After the first UPA treatment course, menorrhagia was improved in 82.2% of patients. A total of 59.5% of patients were responsive to treatment, and the volume of the three largest fibroids decreased from 160.9 cm3 to 104.6 cm3. After the fourth treatment course, 87.4% of patients reported decreased bleeding. A total of 67.2% of patients were responsive to treatment, and the volume of the three largest fibroids decreased from 171.7 cm3 to 106.5 cm3. In 64 (38.1%) patients in group A and 36 (30.3%) in group B, the fibroid volume increased. Among them, 72% of patients showed improved symptoms. Uterine bleeding, pain, and reduced fibroid volume were adequately regulated in patients with symptomatic fibroids with four repeated 12-week courses of daily UPA.

Monitored Anesthesia Care in Uterine Artery Embolization for Leiomyomas and Adenomyosis

Background: Patients undergoing an interventional radiology procedure report some degree of anxiety. Therefore, procedure-related anxiety needs to be managed. The aim of our study was to investigate patient satisfaction with monitored anesthesia care (MAC) for uterine artery embolization (UAE)-related procedural anxiety in symptomatic uterine fibroids or adenomyosis. Methods: Between May 2021 and June 2022, 36 patients with symptomatic fibroids or adenomyosis underwent UAE with MAC. Follow-up evaluations consisted of clinical symptoms, degree of satisfaction with MAC in UAE, and complications. Results: MAC in UAE was successfully performed in all patients. UAE significantly reduced patients’ complaints such as bleeding and pain: the scores for bleeding and pain were significantly reduced after 3 months of UAE compared with those before UAE, indicating the effectiveness of UAE. The mean score of satisfaction with MAC in UAE was 4.3 points, meaning that 94.4% of women were satisfied or very satisfied. No major complications were observed. Conclusions: MAC in UAE for symptomatic uterine fibroids or adenomyosis can be emotionally effective and safe for patients who are anxious about the procedure.

Efficacy of intra-arterial lidocaine administration on pain and inflammatory response after uterine artery embolization for symptomatic fibroids.

There have been conflicting outcomes regarding the use of lidocaine to reduce pain after uterine artery embolization (UAE). To investigate the efficacy of intra-arterial lidocaine injection for pain and inflammatory response control within 24 h of UAE for symptomatic uterine fibroids. Of 1530 patients who underwent UAE for uterine fibroids in 2007-2021, 5 mL of 1% lidocaine was injected into each uterine artery immediately after UAE in 23 patients. A disease-matched control group (n = 23) who did not receive intra-arterial lidocaine was generated from the same registry. The pain score, white blood cell (WBC) count, C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR), and fentanyl consumption were compared before and after UAE. Complete infarction of the dominant fibroid was assessed using magnetic resonance imaging. Significantly lower WBC count, CRP level, and NLR were noted 24 h after UAE in the lidocaine group. No statistically significant difference was noted in the pain score between groups at 0-24 h. The cumulative fentanyl dose administered during the first 24 h after UAE was not significantly different. After embolization, fibroid-related symptoms resolved in all patients. No significant difference was observed in the rate of complete infarction of the dominant fibroid. Lidocaine administration immediately after UAE resulted in a significant reduction in the inflammatory response. However, such a difference in the inflammatory reaction did not contribute to significant reductions in pain scores or fentanyl consumption.

Technical Success and Safety of Transradial Uterine Artery Embolisation for Symptomatic Fibroids at a Single Centre in South Africa

Abstract Background The femoral artery has remained the primary means of vascular access for uterine artery embolisation in the treatment of uterine fibroids. Transradial access for coronary artery catheterization is gaining wider acceptance, with studies in the cardiac literature demonstrating key advantages. The primary objective of this study was to compare the technical success and safety of the transradial approach for uterine artery embolization performed at a single centre in South Africa. Methods Data was obtained from consecutive patients undergoing uterine artery embolisation for the treatment of symptomatic fibroids over a 30-month period. Specifically technical success and patient safety were analysed. Results A total of 496 patients were included in the study. Of these 27 patients had primary contraindications to radial access. The remaining 469 patients who underwent radial artery access, technical success was achieved in 459 cases (97.9%). The primary cause of technical failure was radial artery spasm (9.9%). Mean procedure times were 53.5 minutes ± 15.2 minutes with total screening times of 9.6 ± 9.1 minutes. The mean radiation dose area product was 6321.7 ± 3449.8 cGy.cm2. Complications were recorded in 40 (8.5%) patients, of which 7 (1.5%) were major complications. Conclusions This study corroborates evidence that this approach is a safe and effective alternative to the traditional transfemoral route for the treatment of uterine fibroids.