Prospective evaluation of uterine artery embolization using diluted NBCA-lipiodol mixture for uterine fibroids: preliminary treatment outcomes.

Abstract

Background: This study aimed to determine the safety and effectiveness of uterine artery embolization using NBCA - lipiodol mixture via radial artery access for the treatment of uterine fibroids.

Methods: Forty patients underwent uterine artery embolization with NBCA mixed with lipiodol (1:10). The uterine fibroid volumes were determined on magnetic resonance imaging before and 3-6 months after the procedure. We analyzed the following parameters: dominant fibroid volume, hemoglobin levels, symptoms before treatment, after embolization, and complications.

Results: The mean age was 41 ± 6.5 years and mean uterine volume prior to treatment, 137.7 ± 104.3 ml. After 3-6 months embolization, the mean fibroid volume decreased from 137.7 ± 104.3 cm³ to 51 ± 54.3 cm³ (p < 0.001), corresponding to a mean volume reduction of 64.7 ± 22.7%. Hemoglobin levels also significantly increased (p < 0.001). No major intraprocedural adverse events were observed. Major complications occurred in 2.5% (fibroid expulsion). The minor complications rate was 20%, related to post-embolization syndrome (pain). The late adverse events occurred in 10%: alopecia (7.5%), vaginal dryness (2.5%). The length of hospital stay was 1.9 ± 0.8 days. Clinical symptomatic improvement was observed in 100% and symptoms were resolved in 87.5%.

Conclusion: This prospective single-arm study suggests that UAE using a diluted NBCA-lipiodol mixture is feasible and appears to be safe, with encouraging early clinical and MRI outcomes. However, the short follow-up period, absence of a comparative control group, and lack of direct assessment of fibroid infarction preclude definitive conclusions regarding its efficacy or its role relative to established particulate embolic agents.