Research Article

Experience with trans radial uterine artery embolisation for uterine fibroids in a tertiary center in Saudi Arabia

Gehan Farid*, Reem Kamal, Mohammed Thani Al-Shammari, Mohamed Swaraldahab and Hassan Swaraldahab

Published: 01 December, 2020 | Volume 3 - Issue 2 | Pages: 167-174

Trans-radial uterine artery embolization (UAE) is acknowledged as a non- invasive, cost-effective and safe procedure for the treatment of symptomatic fibroids. However, it is associated with the recurrence of symptoms like abnormal uterine bleeding and pressure symptom in some patients. This is a comparative study of our data with other international data, in the context of percentage reduction in fibroid size, accompanying controlling factors, short and long term follow up data analysis of the first two years was done. Careful pre-procedural counseling of future possibility of fibroid recurrence and means of management should be stressed.

Materials and methods: A retrospective cohort study at the Security Forces Hospital in Riyadh, Saudi Arabia, was conducted. The study was done from 1st November 2017-31st October 2019, on symptomatic patients diagnosed with fibroids, who refused surgical treatment.

The outcomes included: fibroid site, size and anatomical position, patients’ symptoms, general condition, and early and delayed complications. These data were compared with those from other international studies.

Results: The study involved 23 patients (mean age: 39 years). The average percentage reduction in fibroid volume was 49%. There were no major complications and no recurrence of symptoms during the covered period. Data analysis revealed a poor correlation between the overall percentage reduction of fibroid size with fibroid number, age of patients’, and body mass indices.

Conclusion: Despite poor correlation, we provided preliminary data of the first two years out of the total five-year projected period of the study where it showed effectiveness and relative safety of radial - UAE for fibroid.

Read Full Article HTML DOI: 10.29328/journal.cjog.1001072 Cite this Article Read Full Article PDF


  1. Gjoreski A, Gjoreski J, Nancheva A. Uterine Fibroid Embolization via Transradial versus Tran femoral Arterial Access: Technical Results. Open Access Maced J Med Sci. 2019; 7: 579-582. PubMed: https://pubmed.ncbi.nlm.nih.gov/30894915/
  2. Anderson PE. Uterine Artery Embolization of symptomatic uterine fibroid- Initial success and short-term results. Acta Radiologica. 2001; 42: 234-238.
  3. Czuczwar P, Wozniak S, Popajewski M: Predicting the results of uterine artery embolization: correlation between initial intramural fibroid volume percentage decrease. Menopause Review (Prseglad/Menopauzalny). 2014; 13: 247-252. PubMed: https://pubmed.ncbi.nlm.nih.gov/26327862/
  4. Freed MM, Spies JB. Uterine artery embolization for fibroids: a review of current outcomes. Semin Reprod Med. 2010; 28: 235-241. PubMed: https://pubmed.ncbi.nlm.nih.gov/20414846/
  5. Van der Kooij SM, Hehen Kamp WJK, Volkers N A, Birnie E, Ankum W M, Reekers J.A. Uterine artery embolization vs hysterectomy in the treatment of symptomatic uterine fibroid: 5-year outcome from the randomized EMMY trial. Am J Obstet Gynecol. 2010; 203: 105-113. PubMed: https://pubmed.ncbi.nlm.nih.gov/20579960/
  6. Moss JG, Cooper KG, Khaund A. Randomized comparison of uterine artery embolization (UAE) with surgical treatment in patients with symptomatic uterine fibroids (REST trial): 5-year results. BJOG. 2011; 118: 936-944. PubMed: https://pubmed.ncbi.nlm.nih.gov/21481151/
  7. Coleman P, Ayiku L, Nicholl J. Systemic review of the efficacy & safety of uterine artery embolization in the treatment of fibroids. Sheffield: Review Body for Interventional Procedures. 2004.
  8. Volkers NA, Hehenkamp WJK, Birnie E. Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids: 2 years outcome from the randomized EMMY trial. Am J Obstet Gynecol. 2007; 196: 519. PubMed: https://pubmed.ncbi.nlm.nih.gov/17547877/
  9. Hehen Kamp WJK, Volkers NA, Birnie E, Reekers JA, Ankum WM. Symptomatic uterine fibroids: treatment with uterine artery embolization or hysterectomy results from the randomized clinical embolization versus hysterectomy (EMMY) trial. Radiology. 2008; 246: 823-832. PubMed: https://pubmed.ncbi.nlm.nih.gov/18187401/
  10. Spies JB, Bruno J, Czeyda-Pommer Sheim F, Magee ST, Ascher SA, et al. Long term outcome of uterine artery embolization of Leiomyomata. Obstet Gynecol. 2005; 106: 933-939. PubMed: https://pubmed.ncbi.nlm.nih.gov/16260509/
  11. Grady EA, Moss JG, Belli AM, Thomas S, Nicholl J, et al. UK Uterine artery embolization for fibroids registry 2003-2008. The British Society of Interventional Radiology & School of Health and related research.
  12. Dariushnia S, Nikolie B, Strokes L, Spies J. Quality improvement Guidelines for uterine Artery Embolization for Symptomatic Leiomyomata. J Vasc Interv Radiol. 2014; 25: 1737-1747. PubMed: https://pubmed.ncbi.nlm.nih.gov/25442136/
  13. Hirst A, Dutton S, Wu O, Briggs A, Edwards C, et al. A Multi-Centre retrospective cohort study comparing hysterectomy and uterine artery embolization for the treatment of symptomatic uterine fibroids. The HOPEFUL Study. 2008; 12: 1-248. PubMed: https://pubmed.ncbi.nlm.nih.gov/18331704/
  14. Clinical recommendation on the use of uterine artery embolization (UAE) in the management of fibroids. Royal College of Obstetrics and Gynecologist and the Royal College of Radiologist. 3rd edition. 2013.
  15. Schirf BE, Vogelzang RL, Chrisman HB Complications of Uterine Fibroid Embolization. Semin Intervent Radiol. 2006; 23: 143-149. PubMed: https://pubmed.ncbi.nlm.nih.gov/21326757/
  16. Payne JF, Haney AF. Serious complications of uterine artery embolization for conservative treatment of fibroids. Fertility and Sterility. 2003; 79: 128-131.
  17. Spies JB, Myers ER, Worthington-Kirsch R, Mulgund J, Goodwin S, et al. The Fibroid registry: symptom and quality of life status 1 year after therapy. Obstet Gynecol. 2005; 106: 1309-1318. PubMed: https://pubmed.ncbi.nlm.nih.gov/16319257/
  18. Moss J. Christie A. Uterine artery embolization for heavy menstrual bleeding. Women Health (Lond). 2016; 12.71-77. PubMed: https://pubmed.ncbi.nlm.nih.gov/26756068/
  19. Laios A, Baharuddin N, lliou K, Gubara E, O’Sullivan G. Uterine artery embolization for treatment of symptomatic fibroids; a single institution experience. Hippokratia; 2014; 18: 258-261. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4309148/
  20. Lund N, Justesen P, Elle B, Thompson SG, Floridon C. Fibroids treated by uterine artery embolization. A review. Acta Obstet Gyecol Scand. 2000; 79: 905-910.
  21. Lohle PN, Voogt MJ, De Vries J, Vervest HAM, Lampmann LEH, et al. Long term outcome of uterine artery embolization for symptomatic uterine Leiomyomata. Journal of vascular Intervent Radiology. 2008; 19: 319-326. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933812/
  22. Firouznia K, Ghanaati H, Jalali AH. Uterine artery embolization in 101 cases of uterine fibroids: Do size, location and number of fibroids affect therapeutic success and complications? Cardiovascular and Interventional Radiology. 2008; 31: 521-526. PubMed: https://pubmed.ncbi.nlm.nih.gov/18219521
  23. de Souza NM, Williams AD. Uterine arterial embolization for Leiomyomas: Perfusion and volume changes at MR imaging and relation to clinical outcome. Radiology. 2002; 222: 367-374. PubMed: https://pubmed.ncbi.nlm.nih.gov/11818601/
  24. Spies JB, Roth AR, Jha RC, Gomez-Jorge J, Levy EB, et al. Leiamyomata treated with uterine artery embolization: factors associated with successful symptom and imaging outcome. Radiology. 2002; 222: 45-52. PubMed: https://pubmed.ncbi.nlm.nih.gov/11756703/
  25. Naguib NNN, Mbalisike E, Nour-Eldin NA, Jost A, Lehnert T, et al. Leiamyoma volume changes at follow up after uterine artery embolization. Correlation with the initial leiomyoma volume and location. J Ascher Interv Radiol. 2010; 21: 490-495. PubMed: https://pubmed.ncbi.nlm.nih.gov/20149688/
  26. Jha RC, Ascher SM, Imoaka I, Spies JB. Symptomatic fibroleiomyama: MR imaging of the uterus before and after uterine artery embolization. Radiology. 2000; 217: 228-235. PubMed: https://pubmed.ncbi.nlm.nih.gov/11012449/
  27. Sweets AJ, Nijenhuis RJ, Rooij WJ, Weimar EAM, Boekkooi PF, et al. Uterine artery embolization in patients with a large fibroid burden: long term clinical and MR follow up. Cardiovasc Intervent Radiol. 2010; 33: 943-948. PubMed: https://pubmed.ncbi.nlm.nih.gov/20066419/
  28. Sasa H, Kaji T, Furuya K. Indications and outcome of uterine artery Embolization in patient with Uterine Leiomyomas. Obstet and Gyncol International. 2012; Article ID 920831. PubMed: https://pubmed.ncbi.nlm.nih.gov/22135681/
  29. Siskin GP, Tublin ME, Stain Ken BF, Dolen EG, Dowling K. Uterine Artery Embolization for the treatment of Adenomyosis. Clinical response and evaluation with MR imaging. Am J Roentgenol. 2001; 177: 297-302. PubMed: https://pubmed.ncbi.nlm.nih.gov/11461849/
  30. Carrillo TC. Uterine artery embolization in the Management of symptomatic uterine fibroids: An overview of complication and follow up. Semin Intervent Radiol. 2008; 25: 378-386. PubMed: https://pubmed.ncbi.nlm.nih.gov/21326579/
  31. Mclucas B, Adler L, Perrella R. Uterine fibroid embolization: nonsurgical treatment for symptomatic fibroids. J Am College Surg. 2001; 19: 195-105. PubMed: https://pubmed.ncbi.nlm.nih.gov/11192931/
  32. Kim MD, Lee M, Jung DC, Won JY, Lee DY, et al. Limited Efficacy of Uterine Artery Embolization for cervical Leiomyomas Clinical Study. 2012; 23: 236-240. PubMed: https://pubmed.ncbi.nlm.nih.gov/22177843/
  33. Mailli L, Auyoung EY, Angileri SA, Renani SA, Ratnam L, et al. Predicting the fibroid Migratory Impact of UAE: Role of Pre embolization MRI characteristics. Cardiovascular Interventioal Radiology. 2020; 43: 453-458. PubMed: https://pubmed.ncbi.nlm.nih.gov/31650245/
  34. Tulandi T. Fertility and Uterine artery embolization. Obstet Gynecol. 2010; 116: 439-440.
  35. Aziz A, Retrucco OM, Makinoda S. Trans arterial embolization of the uterine arteries, patient reactions and effects on Uterine vasculature. Acta obstet Gynecol Scand. 2003; 77: 334-340. PubMed: https://pubmed.ncbi.nlm.nih.gov/9539283/
  36. Siskin GP, Tublin ME, Stainken I, Dawling K, Dolen EG. Uterine Artery Embolization for the treatment of Adenomyosis. Clinical Response and Evaluation with MRI imaging. Am J Roentgenol. 2001; 177: 297-302. PubMed: https://pubmed.ncbi.nlm.nih.gov/11461849/
  37. Yamashita Y, Torashima M, Takahashi M, Tanak N, Katabuchi H, et al. Hyper intense uterine leiomyoma at T2 weighted MR imaging: differentiation with dynamic enhanced MR imaging and clinical implications. Radiology. 1993; 189: 721-725. PubMed: https://pubmed.ncbi.nlm.nih.gov/8234695/
  38. Spies JB, Bruno J, Czeyda-Pommersheim F, Magee ST, Ascher SA, et al. Long term outcome of uterine artery embolization of Leiomyomata. Obstet Gynecol. 2005; 106: 933-939. PubMed: https://pubmed.ncbi.nlm.nih.gov/16260509/
  39. Limpscomb GH. Uterine Artery Embolization and Minimally Invasive Techniques for Uterine Fibroids. The global Library of Women’s medicine. 2008.
  40. Elsharkawy AM, Elsaeed HH, Kamel AH, Morgan R, El Shafey MH. Comparison between the outcome of single versus multiple uterine fibroids after uterine artery embolization. Egyptian J Radiol Nuclear Med. 2020: 51-77.


Figure 1

Figure 1

Figure 1

Figure 2

Figure 1

Figure 3

Figure 1

Figure 4

Similar Articles

Recently Viewed

  • RBD targeted COVID vaccine and full length spike-protein vaccine (mutation and glycosylation role) relationship with procoagulant effect
    Luisetto M*, Tarro G, Farhan Ahmad Khan, Khaled Edbey, Mashori GR, Ahnaf Ilman, Yesvi AR and Latyschev OY Luisetto M*,Tarro G,Farhan Ahmad Khan,Khaled Edbey,Mashori GR,Ahnaf Ilman,Yesvi AR,Latyschev OY. RBD targeted COVID vaccine and full length spike-protein vaccine (mutation and glycosylation role) relationship with procoagulant effect. J Child Adult Vaccines Immunol. 2021: doi: 10.29328/journal.jcavi.1001007; 5: 001-008
  • Stages in COVID-19 vaccine development: The Nemesis, the Hubris and the Elpis
    Vinod Nikhra* Vinod Nikhra*. Stages in COVID-19 vaccine development: The Nemesis, the Hubris and the Elpis. Int J Clin Virol. 2020: doi: 10.29328/journal.ijcv.1001028; 4: 126-135
  • The use of Bacillus thuringiensis to control plant-parasitic nematodes
    Yolanda Bel, Magda Galeano, Mireya Baños-Salmeron and Baltasar Escriche* Yolanda Bel,Magda Galeano,Mireya Baños-Salmeron,Baltasar Escriche*. The use of Bacillus thuringiensis to control plant-parasitic nematodes. J Plant Sci Phytopathol. 2022: doi: 10.29328/journal.jpsp.1001076; 6: 062-064
  • Fibromuscular dysplasia and aortic dissection
    Antonio M Puppo*, Manuel Fernández Caro, Sara Martín Sastre, Francisco T Gómez and Jose Mariá López Sánchez Antonio M Puppo*,Manuel Fernández Caro,Sara Martín Sastre,Francisco T Gómez,Jose Mariá López Sánchez. Fibromuscular dysplasia and aortic dissection. J Cardiol Cardiovasc Med. 2022: doi: 10.29328/journal.jccm.1001127; 7: 023-025
  • Save the radial: go distally
    Rima Chaddad, Hussein Rabah, Batoul Awada* and Malek Hmadeh Rima Chaddad,Hussein Rabah,Batoul Awada*,Malek Hmadeh. Save the radial: go distally. J Cardiol Cardiovasc Med. 2022: doi: 10.29328/journal.jccm.1001128; 7: 026-029

Read More

Most Viewed

Read More