Uterine artery embolization can be considered for well controlled symptomatic leiomyomas
A new study published in the April 2019 issue of the American Journal of Roentgenology (AJR) investigates the safety of uterine artery embolization (UAE) for symptomatic leiomyomas in patients with various autoimmune diseases.
Between January 2007 and June 2018, 1183 consecutive patients underwent UAE for symptomatic leiomyomas at Yonsei University College of Medicine. Nine of those patients with autoimmune disease ranging in age from 34-49 years (mean age of 42.6 years) were included in the study, "Uterine Artery Embolization in Patients With Autoimmune Disease: A Matched Case-Control Study." All UAE procedures were performed by one interventional radiologist with 16 years of UAE experience.
Using the patient registry, researchers randomly generated an age- and disease-matched control group (n = 8) to compare volume reduction rates of the uterus and dominant leiomyoma and the change in C-reactive protein (CRP) levels before and after UAE to evaluate the safety and effectiveness of UAE in patients with autoimmune disease. The authors defined clinical success as "improvement or resolution of symptoms" following UAE and technical success as "successful embolization of the bilateral uterine arteries."
UAE was technically and clinically successful in all patients in both groups. No significant difference was found between the autoimmune and control groups in the volume reduction rates of uterus and dominant leiomyoma. However, CRP level in the autoimmune patient group was found to be significantly higher 1 day after UAE (1.23 ± 0.6 mg/L vs 9.54 ± 6.63 mg/L; p = 0.001).
While the authors conclude UAE appears to be safe and effectual in the management of symptomatic leiomyoma in patients with autoimmune disease that is well controlled, they note that due to the inclusion of a variety of autoimmune diseases in the case series, a small sample size, and the retrospective nature of the study, the results should be interpreted with some caution.