Uterine Fibroid Embolization via Transradial versus Transfemoral Arterial Access: Technical Results
DOI:
https://doi.org/10.3889/oamjms.2019.163Keywords:
Transradial, Embolization, Fibroids, accessAbstract
AIM: This study was designed to compare the safety and feasibility of uterine fibroid embolisation (UFE) via transradial access (TRA) and transfemoral access (TFA).
MATERIAL AND METHODS: A retrospective analysis was conducted for 2 cohorts: 13 cases with already established TFA (from February 2016 to September 2018) and the first 11 procedures performed via TRA (from October 2017 to October 2018). Indications for embolization included: heavy menstrual bleedings (n = 18), lower urinary tract symptoms (n = 2), pelvic pain (n = 3) and abdominal pain (n = 1). One interventional radiologist and one fellow performed all procedures at one institution. Technical success, procedural time, access site complications as well as feedback from patients were assessed for analysis.
RESULTS: Technical success was achieved in 24/24 cases (100%). Unilateral uterine artery embolisation was performed in 7 cases (29.1%) and bilateral in 17 cases (70.8%). Mean procedure time was 72.4 minutes in TFA group, and 60.3 minutes in the TRA group. Mean fluoroscopy time was 25.3 minutes in the TFA group and 21.1 minutes in the TRA group. Access site-related and overall adverse events did not vary significantly among the study cohorts.
CONCLUSIONS: TRA represents a safe and feasible approach for UFE with a comparable safety profile to TFA.
Downloads
Metrics
Plum Analytics Artifact Widget Block
References
Resnick NJ, Kim E, Patel RS, Lookstein RA, Nowakowski FS, Fischman AM. Uterine artery embolization using a transradial approach: initial experience and technique. Journal of Vascular and Interventional Radiology. 2014; 25(3):443-7. https://doi.org/10.1016/j.jvir.2013.11.010 PMid:24581468
Spies JB, Pelage JP, editors. Uterine artery embolization and gynecologic embolotherapy. Lippincott Williams & Wilkins, 2005.
Gonsalves C. Uterine artery embolization for treatment of symptomatic fibroids. Semin Intervent Radiol. 2008; 25:369–377. https://doi.org/10.1055/s-0028-1103001 PMid:21326578 PMCid:PMC3036525
Ravina JH, Ciraru-Vigneron N, Bouret JM, Herbreteau D, Houdart E, Aymard A, Merland JJ. Arterial embolisation to treat uterine myomata. The Lancet. 1995; 346(8976):671-2. https://doi.org/10.1016/S0140-6736(95)92282-2
Cooper CJ, El-Shiekh RA, Cohen DJ, Blaesing L, Burket MW, Basu A, Moore JA. Effect of transradial access on quality of life and cost of cardiac catheterization: a randomized comparison. American heart journal. 1999; 138(3):430-6. https://doi.org/10.1016/S0002-8703(99)70143-2
Feldman DN, Swaminathan RV, Kaltenbach LA, Baklanov DV, Kim LK, Wong SC, Minutello RM, Messenger JC, Moussa I, Garratt KN, Piana RN. Adoption of radial access and comparison of outcomes to femoral access in percutaneous coronary intervention: an updated report from the national cardiovascular data registry (2007–2012). Circulation. 2013; 127(23):2295-306. https://doi.org/10.1161/CIRCULATIONAHA.112.000536 PMid:23753843
Kröncke T, David M. Uterine Artery Embolization (UAE) for Fibroid Treatment: Results of the 6th Radiological Gynecological Expert Meeting. 2017; 189(6):511-514.
Basile A, Rebonato A, Failla G, Caltabiano G, Boncoraglio A, Gozzo C, Motta A, Foti PV, Palmucci S, GarcÃa AJ, Garcia-Medina J. Early post-procedural patients compliance and VAS after UAE through transradial versus transfemoral approach: preliminary results.Radiol Med. 2018; 123(11):885-889. https://doi.org/10.1007/s11547-018-0920-5 PMid:30019107
Vuurmans T, Hilton D. Brewing the right cocktail for radial intervention. Indian Heart Journal. 2010; 62(3):221-5. PMid:21275297
Goodwin SC, Bonilla SC, Sacks D, Reed RA, Spies JB, Landow WJ, Worthington-Kirsch RL. Reporting standards for uterine artery embolization for the treatment of uterine leiomyomata. Journal of vascular and interventional radiology. 2003; 14(9):S467-76. https://doi.org/10.1097/01.RVI.0000094620.61428.9c PMid:14514862
Scheurig-Muenkler C, Powerski MJ, Mueller JC, Kroencke TJ. Radiation exposure during uterine artery embolization: effective measures to minimize dose to the patient. Cardiovascular and interventional radiology. 2015; 38(3):613-22. https://doi.org/10.1007/s00270-014-0962-6 PMid:25148920
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2019 Aleksandar Gjoreski, Josif Gjoreski, Andrea Nancheva
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
http://creativecommons.org/licenses/by-nc/4.0