Symptomatic Uterine Leiomyomata Research Articles

Multiomic analysis of uterine leiomyomas in self-described Black and White women: molecular insights into health disparities

Black women are at an increased risk to develop uterine leiomyomas (ULMs) and to experience worse disease prognosis compared to White women. Epidemiological and molecular factors have been identified as underlying these disparities, but there remains a paucity of deep, multi-omic analysis investigating molecular differences in ULMs from Black and White patients. To identify molecular alterations within ULM tissues correlating with patient race by multi-omic analyses of ULMs collected from cohorts of Black and White women. We performed multi-omic analysis of ULMs from Black (42) and White (47) women undergoing hysterectomy for symptomatic uterine leiomyomata. Our analysis also included application of orthogonal methods to evaluate fibroid biomechanical properties, such as second harmonic generation microscopy, uniaxial compression testing, as well as sheer wave ultrasonography analyses. We found a greater proportion of mediator complex subunit 12 (MED12) mutant ULMs from Black women (>35% increase, Mann Whitney U p = 7E-4). MED12 mutant tumors exhibited elevated abundance of extracellular matrix proteins, including several collagen isoforms, involved in regulation of the core matrisome. Histological analysis of tissue fibrosis using trichrome staining and secondary harmonic generation microscopy confirmed that MED12 mutant tumors are more fibrotic than MED12 wildtype tumors. Using Sheer Wave ultrasonography in a prospectively collected cohort, Black patients had fibroids that were firmer when compared to White patients, even when similar in size. These analyses also uncovered expression quantitative trait loci (eQTL) associated with altered allele frequencies in African and European populations that correlated with differential abundance of several proteins in ULM that are independent of MED12 mutational status, including multiple eQTL mapping to tetratricopeptide repeat protein 38. Our study shows that Black women have a higher prevalence of ULMs harboring mutations in MED12 and that this mutational status correlates with increased tissue fibrosis in comparison with wildtype ULMs. Our study provides insights into molecular alterations underlying racial disparities in ULMs and improves our understanding of the molecular etiology underlying ULM development within these populations.

Prevalence and burden of symptomatic uterine leiomyomata among women in Imo State, South-Eastern Nigeri

Prevalence and burden of symptomatic uterine leiomyomata among women in Imo State, South-Eastern Nigeri

Prevalence and burden of symptomatic uterine leiomyomata among women in Imo State, South-Eastern Nigeri

Despite high rates of Uterine Leiomyomata (UL) diagnoses found in black women, there is paucity in research. Therefore, this study aimed at estimating the prevalence and burden of symptomatic UL among women in Imo State, Nigeria. The study is a descriptive cross-sectional hospital-based study that was carried out in Radiology, Obstetrics and Gynaecology departments of three hospitals and two diagnostic Centres covering the three senatorial zones in Imo State. The research was based on a convenience sampling of 2965 women within the age group of 16 to 49 that reside in the 3 senatorial zones referred for an ultrasound scan and who met the selection criteria within the period of study. Eligible and consented women responded to the questionnaire and underwent a transabdominal ultrasound. The data were analysed with the statistical program PASW 18 and p values < 0.05 were taken to be statistically significant. Weighted means and percentages were reported and prevalence across the senatorial zones was examined. Symptom burden among women with and without uterine fibroids was compared using weighted logistic regressions. Of 2965 respondents who met study inclusion criteria, a total of 652(22.0%) were diagnosed having UL while 2313 (78.0%) do not have the disease. Hence the overall prevalence of UL at clinics/Diagnostic centres in Imo State was 22%. Uterine fibroids impose a heavy burden on women aged 16–49 years in Imo State. It represents an important gynecologic pathology in women due to its relatively high prevalence and its significant impact on patient’s quality of life.

Utilization of Endovascular and Surgical Treatments for Symptomatic Uterine Leiomyomas: A Population Health Perspective

PurposeTo conduct a population-level analysis of surgical and endovascular interventions for symptomatic uterine leiomyomata by using administrative data from outpatient medical encounters. Materials and MethodsBy using administrative data from all outpatient hospital encounters in California (2005–2011) and Florida (2005–2014), all patients in the outpatient setting with symptomatic uterine leiomyomata were identified. Patients were categorized as undergoing hysterectomy, myomectomy, uterine artery embolization (UAE), or no intervention. Hospital stay durations and costs were recorded for each encounter. ResultsA total of 227,489 patients with uterine leiomyomata were included, among whom 39.9% (n = 90,800) underwent an intervention, including hysterectomy (73%), myomectomy (19%), or UAE (8%). The proportion of patients undergoing hysterectomy increased over time (2005, hysterectomy, 53.2%; myomectomy, 26.9%; UAE, 18.0%; vs 2013, hysterectomy, 80.1%; myomectomy, 14.4%; UAE, 4.0%). Hysterectomy was eventually performed in 3.5% of patients who underwent UAE and 4.1% who underwent myomectomy. Mean length of stay following hysterectomy was significantly longer (0.5 d) vs myomectomy (0.2 d) and UAE (0.3 d; P < .001 for both). The mean encounter cost for UAE ($3,772) was significantly less than those for hysterectomy ($5,409; P < .001) and myomectomy ($6,318; P < .001). Of the 7,189 patients who underwent UAE during the study period, 3.5% underwent subsequent hysterectomy. ConclusionsThe proportion of women treated with hysterectomy in the outpatient setting has increased since 2005. As a lower-cost alternative with a low rate of conversion to hysterectomy, UAE may be an underutilized treatment option for patients with uterine leiomyomata.

Assessing Safety and Efficacy of Uterine Artery Embolization in Symptomatic Uterine Fibroids

AbstractBackground: Uterine artery embolization (UAE) is a modality for management of symptomatic uterine leiomyomata. UAE for uterine fibroids in Egypt is a procedure with minimal reported data.Aim of Study: To determine safety and efficacy of UAE in treating uterine leiomyomata in Egyptian population.Patients and Methods: 45 consecutive patients undergoing UAE for uterine leiomyomata management were questioned for fibroid associated manifestation and symptomatic improve-ment at predetermined follow-up clinical visits. Data were obtained via verbal questionnaire.Data collected included early, late procedural related complications and possible gynecological interventions were gathered.Follow-up imaging by MRI at three and six months was carried out in order to measure reduction in uterine, dominant leiomyomata volume post-UAE.Results: Technical success was achieved in 100% of patients. No significant complication took place with no necessary post procedural-related gynecological interventions.Follow-up duration was 6 months. Heavy menstrual bleeding improved in 91.1% of patients at 3 months and in 95.6% at 6 months post treatment. Pressure-related symptoms improved in 84.4% of patients at 3 months and in 95.6% at 6 months after treatment. Convenient control of pain was evident in 55.6% of patients at 3 months and in 73.3% at 6 months post-UAE. MRI showed highly significant reduction in uterine as well as dominant fibroid volumes (24.4, 31.1 % at 3, 6 months), (33.3, 44.4% at 3, 6 months) respectively.Conclusion: Uterine artery embolization is an effective procedure in treatment of symptomatic uterine leiomyomata with reduced post-procedural complications.

Measurement of Uterine Leiomyomata Volume Pre and Post Uterine Artery Embolization Aided by MRI

Background: uterine fibroid embolization (UFE) is now evolving to be the first-line treatment for symptomatic uterine leiomyomata alongside the conventional surgical treatment of hysterectomy and myomectomy. Cochrane review comprises six RCTs comparing UAE versus hysterectomy or myomectomy for management of symptomatic leiomyomata where UFE had similar short and midterm outcomes, inclusive of symptomatic relief, quality of life and patient satisfaction, while benefiting from uterine preservation, shorter hospital stay and a faster recovery before resuming ordinary life activities. These benefits are in line with the minimally invasive nature of the embolization procedures. Aim of the Work: t this study aimed to review and illustrate the role of MR imaging in the pre- and post-procedural assessment for uterine fibroid patients undergoing uterine artery embolization. Patients and Methods: the current study was carried out in Radiodiagnosis Department, Faculty of Medicine, Ain shams University and specialized private radiology centers during the period between April 2017 and December 2017. It included 30 patients that were referred from gynecology clinic with their ultrasonographic reports to Radiodiagnosis Department, body imaging unit with a view to carry-out pelvic MRI with contrast. Results: imaging follow-up via pelvic MRI with contrast was obtained in 30 patients at 3, 6 months after treatment. The mean uterine volume was reduced by 25% (standard deviation was SD 0.03763) 3 months after treatment and was further reduced by a mean of 30% (SD 0.02638) by six months after treatment. Post-procedural subtraction MRI revealed mean myoma enhancement to be 5.6 + 0.5 SI in contrast to 133.4 + 18.3 SI prior to UFE. The mean dominant fibroid volume reduced by 34 % (SD 0.09247) after 3 months, 44 % (SD 0.05994) after 6 months. A cumulative reduction in both uterine and dominant leiomyoma mean volume from baseline to 6 months post – UAE was evident with significant interval changes between 3, 6 months follow up (p 0.000) Conclusion: the MRI findings following UAE vary with the interval from embolization and success of the procedure. MRI with its multiplanar capabilities was typically employed to evaluate the uterus following UAE for fibroid infarction, size reduction, location change, persistent enhancement, fibroid recurrence, changes in adenomyosis, and unexpected complications that may require surgical intervention or identify women who would benefit from repeated UAE. Recommendations: further studies on a larger scale of patients are needed to confirm the results obtained by this work.

Effects of obesity on the development of uterine leiomyomata: a retrospective study of 169 women who had myomectomy in southern Nigeria

This is a retrospective study of 169 women who had myomectomy for symptomatic uterine leiomyomata in Lagos, Nigeria between January 1, 2008 and December 31, 2012. This study aimed at ascertaining the relationship between uterine leiomyomata and obesity. The patients in this series were in their reproductive age with peak incidence amongst the 35-44 years age group (57.23% of study population). Majority of these subjects (69.16%) were obese (BMI ≥ 25 in this series). They were predominantly nulliparous women (83.23%) and mostly of the middle socioeconomic class. There was no statistical significant difference between social class and obesity, duration of symptom and preoperative uterine size, parity and pre-operative uterine size, parity and number of fibroid nodules shelled out at surgery, and between obesity and the number of fibroids shelled out at surgery. The commonest post-operative complications were haemorrhage (42.86%), anaemia (32.65%), sepsis (12.24%) and wound dehiscence (10.20%). A statistical significant association exists between obesity and development of post-operative complications but NOT in the overall morbidity of patients with fibroids in terms of duration of hospitalization. In conclusion, obesity does not appear to influence growth of uterine leiomyomata but impacts significantly on occurrence of post-operative complications.

Clinical and Periprocedural Pain Management for Uterine Artery Embolization

Uterine artery embolization has Level A data supporting excellent safety and efficacy in treating symptomatic uterine leiomyomata. However, there is a perception that either postprocedural pain is severe or poorly managed by the physician performing these procedures. This has led some primary care physicians to omit this procedure from the patients' options or to steer patients away from this procedure. A few simple techniques (pruning of the vascular tree and embolizing to 5-10 beat stasis) and fastidious pre-, intra-, and post-procedural management can nearly eliminate significant pain associated with embolization. Specifically, early implementation of long-acting low-dose narcotics, antiemetics and anti-inflammatory medications is critical. Finally, the use of a superior hypogastric nerve block, which takes minutes to perform and carries a very low risk, significantly reduces pain and diminishes the need for narcotics; when this technique was used in a prospective study, all patients were able to be discharged the day of the procedure. In the authors' experience, patients treated in this manner largely recover completely within 5 days and have a far less traumatic experience than patients traditionally treated with only midazolam (Versed) and fentanyl citrate (fentanyl) intraprocedurally, and narcotics and nonsteroidal antiinflammatory drugs postprocedurally.

Vaginal mifepristone for the treatment of symptomatic uterine leiomyomata: an open-label study

To evaluate the efficacy and safety of 3 months of vaginal mifepristone treatment on leiomyoma volume and related symptoms. Prospective, open-label, two tertiary centers, phase II clinical trial. Two tertiary medical centers in Israel. Thirty-three enrolled women, ages 30-53 years, diagnosed with symptomatic uterine fibroids. Patients received 10 mg mifepristone vaginally daily for 3 months. Reduction in uterine leiomyoma volume. Improvement in symptoms related to uterine fibroids was assessed with the use of the "Uterine Fibroid Symptoms Quality of Life Questionnaire" (UFS-QoL). The number of bleeding days, safety, and tolerability were secondary measures. Mifepristone treatment significantly reduced leiomyoma volume from 135.3 ± 22.9 cc at enrollment to 101.2 ± 22.4 cc after 3 months of treatment. The UFS-QoL Score significantly decreased from 20.7 ± 0.7 at enrollment to 14.0 ± 0.8 after 3 months of treatment. The number of bleeding days significantly decreased by 3.5 days. Endometrial biopsies showed no evidence of endometrial hyperplasia or cellular atypia. There were no major side effects during the course of the study, and treatment was well tolerated. Vaginal mifepristone may offer an effective treatment option for women with symptomatic uterine leiomyoma and can improve the patients' quality of life. NCT00881140.

MR-guided High-intensity Focused Ultrasound Treatment for Symptomatic Uterine Leiomyomata: Long-term Outcomes

To evaluate the long-term clinical outcomes of magnetic resonance--guided high-intensity focused ultrasound (MR-g HIFU) treatments for symptomatic uterine leiomyomata. Patients were recruited for a prospective study for MR-g HIFU treatments of symptomatic leiomyomata, with up to 3-year follow-up. The study was approved by the institutional review board and was Health Insurance Portability and Accountability Act--compliant. Clinical assessments were obtained at 3 months, 6 months, and 1, 2, and 3 years after MR-g HIFU, as well as uterine fibroid symptom severity scores (SSS) and health-related quality of life questionnaires (UFS-QOL). MR imaging was performed at each follow-up to assess the efficacy of the treatment at 6 months, 1 year, 2 years, and 3 years. Fifty-one leiomyomata in 40 patients were treated. All patients were treated within the US Food and Drug Administration guidelines with leiomyomata localized on MR and treated with sonication. The mean baseline volume of treated leiomyomata was 336.9 cm(3). The mean improvement scores for transformed SSS was 47.8 (P < .001) and for tUFS-QOL was 39.8 (P < .001) at 3 years. The mean volume decrease in treated leiomyomata was 32.0% (P < .001), and, in the uterus, the volume decrease was 27.7% (P < .001) at 3 years. There were no long-term complications. Long-term follow-up data from MR-g HIFU treatments show sustained symptomatic relief among enrolled patients. Although the results are preliminary, MR-g HIFU for the treatment of uterine leiomyomata may result in acceptable long-term outcomes at 3 years.

Ovarian Artery Embolization in Patients With Collateral Supply to Symptomatic Uterine Leiomyomata

To evaluate the safety and outcome of ovarian artery embolization (OAE) in patients with collateral supply to symptomatic uterine leiomyomata. Thirteen patients with relevant leiomyoma perfusion by way of enlarged ovarian arteries underwent additional OAE during the same (N = 10) or a second procedure (N = 3). Uterine artery embolization (UAE) was performed bilaterally in 10 and unilaterally in 2 patients with a single artery. One patient had no typical uterine arteries but bilaterally enlarged ovarian arteries, prompting bilateral OAE. OAE was accomplished with coil embolization in one and particle embolization in 12 patients. Symptoms before therapy and clinical outcome were assessed using a standardized questionnaire. Contrast-enhanced magnetic resonance (MR) imaging after embolization was available in 11 of 13 patients and was used to determine the percentage of fibroid infarction. UAE and OAE were technically successful in all patients. One patient experienced prolonged irritation at the puncture site. Median clinical follow-up time was 16 months (range 4-37). Ten of 13 patients showed improvement or complete resolution of clinical symptoms. One patient reported only slight improvement of her symptoms. These women presented with regular menses. Two patients (15%), 47 and 48 years, both with unilateral OAE, reported permanent amenorrhea directly after embolization. Their symptoms completely resolved. Seven patients showed complete and 4 showed >90% fibroid infarction after embolization therapy. OAE is technically safe and effective in patients with ovarian artery collateral supply to symptomatic uterine leiomyomata. The risk of permanent amenorrhea observed in this study is similar to the reported incidence after UAE.

Phase I/II Multiinstitutional Study of Uterine Artery Embolization with Gelatin Sponge for Symptomatic Uterine Leiomyomata: Japan Interventional Radiology in Oncology Study Group Study

This multicenter prospective study was conducted to evaluate the safety and the efficacy of uterine artery embolization (UAE) with gelatin sponge for symptomatic leiomyomas. Patients with symptomatic uterine leiomyomas were enrolled and treated with UAE. In phase I, nine patients were evaluated for safety. In phase II, 24 patients were accrued, and an intent-to-treat analysis was performed on all 33 patients. The primary endpoint was safety. Secondary endpoints included technical success, hospital stay, change in symptoms, leiomyoma volume on magnetic resonance (MR) imaging, and incidence of treatment failure. UAE procedures were performed for all 33 patients. Two patients were lost to follow-up at 3 and 12 months. The median follow-up period was 33.4 months. Minor adverse events (AEs) occurred in 10 patients (33%); major AEs of permanent amenorrhea and leiomyoma expulsion occurred in two (6%). The most common AE was transient amenorrhea. Technical success was achieved in all patients. The median hospital stay was 5 days. At 12 months after UAE, menorrhagia had improved in 90% of patients, pelvic pain in 78%, and bulk-related symptoms in 97%. The mean reduction in leiomyoma volume on MR imaging at 12 months was 61%. Treatment failure occurred in one patient, who underwent hysterectomy for recurrent menorrhagia at 21 months. UAE with gelatin sponge is safe, with efficacy comparable to other embolic agents based on published data. Gelatin sponge should be an option for UAE, but a prospective comparison versus other standard UAE embolic agents may be warranted.

Uterine Artery Embolization versus Abdominal Myomectomy: A Long-term Clinical Outcome Comparison

To assess long-term clinical effectiveness of uterine artery embolization (UAE) compared with abdominal myomectomy. Women who received UAE (n = 87) or abdominal myomectomy (n = 98) for symptomatic uterine leiomyomata between 2000 and 2002 at a single institution were consecutively enrolled in this study. Patients whose procedures were performed within 5 years before the study were included. Symptom evaluations with symptom severity scores, pregnancy rates, and satisfaction with the procedures were obtained via institutional review board-approved questionnaires. Chart reviews were performed to supplement analyses. The retrospective cohort included 185 patients, of whom long-term follow-up was completed by 89 patients (48.1%), 48 being treated with UAE, and 41 with myomectomy. Follow-up ranged from 50 to 83 months. A higher but not statistically significant number of patients received repeat interventions after abdominal myomectomy (14%) versus UAE (8%; P = .204). Significantly higher symptom severity score improvements were seen in patients treated with UAE versus abdominal myomectomy (34 vs 31; P = .02). UAE recipients were less likely to attempt to get pregnant (P = .02), but those who did had a 66.7% success rate compared with 58.8% for patients who underwent myomectomy. Similar numbers of patients between groups were satisfied with the procedure (P = .57), reported effectiveness of symptom relief (P = .43), and would recommend the procedure to others (P = .37). UAE results in long-term clinical success with outcomes comparable or superior to those of abdominal myomectomy.

Abdominal myomectomy—a safe procedure in an ambulatory setting

To evaluate the efficacy and safety of minilaparotomy myomectomy in an ambulatory setting. Retrospective, nonrandomized study. Center for Assisted Reproduction, Bedford, Texas. One hundred eighty-nine women desiring fertility with symptomatic uterine leiomyomata. Minilaparotomy myomectomy in an ambulatory setting. Operative time, blood loss, recovery time, postoperative analgesia, and complications. The mean diameter of the largest leiomyoma was 4.4 cm (range, 1-14 cm). The mean number and weight of the leiomyomata was 4.9 (range, 1-35) and 109.8 gm (range, 1-1,165 g), respectively. The mean operative time was 73 minutes, and the mean blood loss was 96 mL. On average, patients required 3.5 hours of recovery time. In the recovery room, patients received a mean of 12 mg of morphine/37 mg of meperidine for pain control postoperatively before discharge home. Only one major complication, pulmonary edema related to extubation, occurred. This study demonstrates that minilaparotomy myomectomy, when performed using a systematic operative technique, can be accomplished in an outpatient setting with minimal blood loss, fast recovery time, and a low complication rate. Postoperatively, patients require minimal analgesia, which permits them to be discharged home the same day. Minilaparotomy myomectomy is a safe, cost-effective treatment of most symptomatic uterine leiomyomata in an ambulatory setting.

Abstract No. 326: Ovarian artery embolization (OAE) accompanying uterine artery embolization (UAE) in patients with collateral supply to symptomatic uterine leiomyomata

Abstract No. 326: Ovarian artery embolization (OAE) accompanying uterine artery embolization (UAE) in patients with collateral supply to symptomatic uterine leiomyomata

Abstract No. 59: Elective use of unilateral uterine artery embolization for symptomatic uterine leiomyomata

Abstract No. 59: Elective use of unilateral uterine artery embolization for symptomatic uterine leiomyomata

Uterine Artery Occlusion for Treatment of Symptomatic Uterine Myomas

To compare the effectiveness and safety of uterine artery occlusion by laparoscopy versus embolization as a treatment modality for symptomatic uterine fibroids. Ninety-six premenopausal women with symptomatic uterine leiomyomata were studied. None of them desired further pregnancy. They were randomized to treatment either by laparoscopic occlusion (group 1) or by radiologic embolization of uterine arteries (group 2). The primary outcome measure was patient satisfaction as regards menstrual blood loss compared with pretreatment loss. Secondary outcome measures included postoperative pain, complications, secondary interventions, and failures. Ninety women were followed for 1, 3, 6, and 12 months after both procedures. The primary outcome was comparable between the 2 groups (86.7% after laparoscopic occlusion versus 88.8% after embolization, with no statistically significant difference). After 12 months of follow-up, more patients resumed heavy periods in the uterine artery occlusion group [4/45 patients, 8.8% in occlusion group compared with 3/45 (6.6%) in embolization group, P=0.044]. Both laparoscopic occlusion and superselective embolization of uterine arteries improved clinical symptoms in the majority of patients. At 12-month follow-up, embolization might be more effective.

A randomized controlled study comparing harmonic versus electrosurgery in laparoscopic myomectomy

To compare the effectiveness and safety of harmonic scalpel versus electrosurgery to reduce blood loss during laparoscopic myomectomy. Prospective randomized controlled study. Tertiary referral centers for gynecological care. One hundred sixty consecutive premenopausal women with symptomatic uterine leiomyomata who were assigned to one of the two treatment groups (a total of 80 patients in each group): treatment with electrosurgery devices with a vasoconstrictive solution (50 mL of saline solution and 0.5 mL of epinephrine [1/2 vial of 1 mg/mL]; group A) or harmonic scalpel (group B). Laparoscopic myomectomy. The global operative time, the time spent for myoma enucleation and for suturing uterine wall defects, and intraoperative blood loss as well as the surgical difficulty degree and postoperative pain at 24 and 48 hours after the laparoscopic procedure. No relevant intra- or postoperative complications were observed in either group. The degree of pain 24 hours after surgery was significantly lower in patients in whom the harmonic scalpel was used. The degree of surgical difficulty did not differ between groups, but the global operative time was significantly shorter in the harmonic scalpel group. The use of the harmonic scalpel for laparoscopic myomectomy is associated with low total operative time, low intraoperative blood loss, and low postoperative pain, with no increase in surgical difficulty.

Embolización de las arterias uterinas en el tratamiento del mioma uterino sintomático. Resultados en 90 pacientes a los 2 años

ObjectiveTo evaluate the mid-term outcomes and patient satisfaction following UAE in women with symptomatic leiomyomata, as well as to assess safety treatment. Material and methodsProspective study of 90 patients from Sabadell Hospital between December 2002 and October 2006.Data were collected using a questionnaire and was later introduced in a specific database. Statistical analysis of data was carried out using SPSS 15.0.All patients went on a 2-year follow-up after UAE, including clinical, laboratory and diagnostic imaging examinations.Symptoms were scored as successful, improvement, unchanged or worsened. Adverse events were noted following the Society of Interventional Radiology's classification. Patients were also asked about their satisfaction.The need of an eventual hysterectomy or the persistence of symptoms was considered to be a treatment failure. ResultsThe improvement of symptoms occurred in 90,7% of all the embolized women. We had to perform a second embolization in 4 cases, and a hysterectomy in 6 cases.6 months later, null vascularisation or hypovascularisation of the myoma was observed in 92.8% of women. Over two years, the average volume reduction of the dominant myoma was 76.3%.The rate of major complications was 12.7%. Patient satisfaction for the procedure was 90.2%. ConclusionsUterine artery embolization is an effective treatment for women with symptomatic uterine leiomyomata, being well accepted by the patients in the mid-term follow-up.

Persistent Sciatic Artery and Successful Uterine Artery Embolization: Report of Three Cases

The incidence of persistent sciatic artery (PSA) was evaluated in the setting of uterine artery embolization (UAE) for symptomatic uterine leiomyomata over a 3-year period. PSA was present in 0.83% of patients or 0.69% of limbs undergoing UAE at a single institution. The authors present three cases of PSA in which successful treatment with UAE was performed. Interventionalists should have thorough anatomic knowledge of PSA, and this rare yet important anatomic variant should be included among the pertinent findings during UAE.