Clinical Results of Fibroid Embolisation, Trials and Registries

Uterine fibroids are the most common tumour to affect women. Many are asymptomatic but when treatment is required there is almost always a choice. Uterine artery embolisation (UAE) is a relatively new minimally invasive technique and is usually one of the

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Contents 1

Introduction..........................................................................

66

2 2.1 2.2 2.3

Evidence ................................................................................ EBM Pyramid ........................................................................ Levels of Evidence ................................................................ Grades of Recommendation (http://www.sign.ac.uk/ guidelines/fulltext/50/annexb.html).......................................

66 66 66

Outcome Measures ..............................................................

67

4 Systematic Reviews and Meta-Analyses ........................... 4.1 Cochrane Review................................................................... 4.2 Systematic Review and Meta-Analysis ................................

67 67 68

Trials ..................................................................................... PINTO.................................................................................... MARA.................................................................................... EMMY ................................................................................... REST...................................................................................... FUME .................................................................................... FEMME .................................................................................

68 68 68 68 69 69 70

6 Registries............................................................................... 6.1 U.S.A. Fibroid Registry......................................................... 6.2 BSIR/NICE UK Registry ......................................................

70 70 70

7 Cohort Studies...................................................................... 7.1 HOPEFUL..............................................................................

71 71

8

Ovarian Function.................................................................

71

9

Fertility and Pregnancy ......................................................

72

10

Complications/Adverse Events ...........................................

72

3

5 5.1 5.2 5.3 5.4 5.5 5.6

R. P. Yadavali Department of Radiology Aberdeen Royal Infirmary, Consultant Interventional Radiologist, Foresterhill, Aberdeen, AB25 2ZN, UK

66

11

Deaths....................................................................................

72

12

Cost-Effectiveness ................................................................

72

Abstract

Uterine fibroids are the most common tumour to affect women. Many are asymptomatic but when treatment is required there is almost always a choice. Uterine artery embolisation (UAE) is a relatively new minimally invasive technique and is usually one of the options. Initially slow to be accepted it is now a recognised, approved and funded procedure in most countries. It is the duty of any doctor to discuss all treatment options available with the patient. This discussion should be based