Transarterial Genicular Artery Embolization as Treatment of Chronic Knee Pain in Patients with Osteoarthritis

Abstract

Background: Uterine artery embolisation (UAE) is an accepted treatment option for the majority of uterine fibroids. UAE in the case of submucosal fibroids is more contentious given the potential risk of expulsion of necrotic material. The aim of this study was to determine the suitability of UAE in cases where submucosal fibroids exist and to assess the procedural outcomes and complications. Method(s): Retrospective data was collected for UAEs conducted over a five-year period at a single tertiary centre. Patients with pre-and post-procedure MRI studies as well as submucosal fibroids were included. Alterations in the volume of the uterus and size of the dominant submucosal fibroid were calculated pre-and post-UAE. Post-UAE complications and surgical interventions were also documented. Patient satisfaction was assessed using the 40-point uterine fibroid symptom quality of life (UFS-QoL) questionnaire. Result(s): Between 2013-2018, 281 female patients underwent UAE. Of these, 26 (9.3%) patients were found to have submucosal fibroids (mean age 47.5±5.0 years; range: 35-56). The mean pre-UAE uterine volume was 986.5±565.1 CC, while mean post-UAE uterine volume was 666.9±542.0 CC (p<0.05). The mean dominant submucosal fibroid size pre-UAE was 5.3±2.5 cm, and post-UAE was 3.25±2.74 cm (p<0.05). 100% of fibroids were effectively devascularised. 7.7% of patients experienced post-UAE pelvic infection. 41.2% patients underwent further surgical intervention, while 58.8% were discharged from clinic. Conclusion(s): UAE is a safe and efficacious treatment option for submucosal fibroids, however a high percentage of patients may require adjunctive surgical intervention to augment therapeutic results.