Ananthakrishnan, G., Murray, L., Ritchie, M., Murray, G., Bryden, F., Lassman, S., Lumsden, M.A. and Moss, J.G. (2013) Randomized comparison of uterine artery embolization (UAE) with surgical treatment in patients with symptomatic uterine fibroids (REST Trial): Subanalysis of 5-year MRI findings. CardioVascular and Interventional Radiology, 36(3), pp. 676-681. (doi: 10.1007/s00270-012-0485-y)
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Abstract
<p>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.</p> <p>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.</p> <p>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).</p> <p>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.</p>
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Bryden, Dr Fiona and Murray, Dr Lilian and Sim, Ms Moira |
Authors: | Ananthakrishnan, G., Murray, L., Ritchie, M., Murray, G., Bryden, F., Lassman, S., Lumsden, M.A., and Moss, J.G. |
College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
Journal Name: | CardioVascular and Interventional Radiology |
Publisher: | Springer Link |
ISSN: | 0174-1551 |
ISSN (Online): | 1432-086X |
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