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Randomized comparison of uterine artery embolization (UAE) with surgical treatment in patients with symptomatic uterine fibroids (REST Trial): Subanalysis of 5-year MRI findings

Research output: Contribution to journalArticle

  • Ganapathy Ananthakrishnan
  • Lilian Murray
  • Moira Ritchie
  • Gordon Murray
  • Fiona Bryden
  • Sue Lassman
  • Mary Ann Lumsden
  • Jon G. Moss

Related Edinburgh Organisations

Original languageEnglish
Pages (from-to)676-681
Number of pages6
JournalCardiovascular and interventional radiology
Volume36
Issue number3
DOIs
Publication statusPublished - 1 Jun 2013

Abstract

Purpose: To report 5-year contrast-enhanced magnetic resonance imaging findings of the REST trial recruits who underwent either uterine artery embolization (UAE) or myomectomy. Methods: A total of 157 patients were randomized to UAE or surgery (hysterectomy or myomectomy). Ninety-nine patients who had UAE and eight patients who had myomectomy were analyzed. MRI scans at baseline, 6 months, and 5 years were independently interpreted by two radiologists. Dominant fibroid diameter, uterine volume, total fibroid infarction (complete 100 %, almost complete 90-99 %, partial <90 %), and new fibroid formation were the main parameters assessed and related to the need for reintervention. Results: In the UAE group, mean ± standard deviation uterine volume was 670 ± 503, 422 ± 353, and 292 ± 287 mL at baseline, 6 months, and 5 years, respectively. Mean dominant fibroid diameter was 7.6 ± 3.0, 5.8 ± 2.9, and 5 ± 2.9 cm at baseline, 6 months, and 5 years. Fibroid infarction at 6 months was complete in 35 % of women, almost complete in 29 %, and partial in 36 %. Need for reintervention was 19, 10, and 33 % in these groups, respectively (p = 0.123). No myomectomy cases had further intervention. At 5 years, the prevalence of new fibroid was 60 % in the myomectomy group and 7 % in the UAE group (p = 0.008). Conclusion: There is a further significant reduction in both uterine volume and dominant fibroid diameter between 6 months and 5 years after UAE. Complete fibroid infarction does not translate into total freedom from a subsequent reintervention. New fibroid formation is significantly higher after myomectomy.

    Research areas

  • Arterial intervention, Embolization, Embolotherapy, Fibroid, Urogenital

ID: 7690607