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DOI: 10.1148/rg.25si055518
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RadioGraphics 2005;25:S119-S132
© RSNA, 2005

Imaging Manifestations of Complications Associated with Uterine Artery Embolization1

Yuri Kitamura, MD2, Susan M. Ascher, MD, Cirrelda Cooper, MD, Sandra J. Allison, MD, Reena C. Jha, MD, Pamela A. Flick, MD and James B. Spies, MD

1 From the Department of Radiology, Georgetown University Hospital, 3800 Reservoir Rd NW, Washington, DC 20007. Presented as an education exhibit at the 2004 RSNA Scientific Assembly. Received May 18, 2005; revision requested May 31 and received June 30; accepted July 12. J.B.S. is a research support consultant for Boston Scientific and Biosphere Medical; all remaining authors have no financial relationships to disclose. Address correspondence to S.M.A. (e-mail: aschers{at}gunet.georgetown.edu).

Uterine artery embolization (UAE) is an increasingly performed, minimally invasive alternative to hysterectomy or myomectomy for women with symptomatic uterine fibroids. A growing body of literature documents symptomatic improvement in the majority of women who undergo UAE. Although UAE is usually safe and effective, there are a number of known complications associated with the procedure. Major complications include fibroid passage, infectious disease (endometritis, pelvic inflammatory disease–tubo-ovarian abscess, pyomyoma), deep venous thrombosis, pulmonary embolism, inadvertent embolization of a malignant leiomyosarcoma, ovarian dysfunction, fibroid regrowth, uterine necrosis, and even death. Minor complications include hematoma, urinary tract infection, retention of urine, transient pain, and vessel or nerve injury at the puncture site. As UAE takes its place in the treatment arsenal for women with symptomatic fibroids, radiologists need to be familiar with UAE-associated complications, which may require further treatment and may even be life threatening in some cases. Knowledge of these complications and their imaging features should lead to prompt diagnosis and appropriate treatment.

© RSNA, 2005






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