Uterine Artery Embolisation of Fibroids and the Phenomenon of Post-Embolisation Syndrome: A Systematic Review

Post-embolisation syndrome (PES) is a prevalent complication that occurs in patients following uterine artery embolisation (UAE) for the treatment of uterine fibroids. The aetiology of PES remains incompletely understood, although postulated to result secondary to tissue infarction resulting in rele...

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Published inDiagnostics (Basel) Vol. 12; no. 12; p. 2916
Main Authors Waldron, Michael G, Kassamani, Yara W, O'Mahony, Alexander T, O'Mahony, Siobhain M, O'Sullivan, Orfhlaith E, Power, Stephen P, Spence, Liam, Maher, Michael M, O'Connor, Owen J, Buckley, Maria M
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 23.11.2022
MDPI
Subjects
Ablation
Blood platelets
Care and treatment
Complications and side effects
Data collection
Embolization
Etiology
Fibroids
Hysterectomy
inflammation
Ischemia
Leiomyoma
Lymphocytes
Menstruation
Neutrophils
Observational studies
Pain
Patients
post-embolisation syndrome
Sepsis
Systematic Review
Uterine artery embolization
Womens health
Ireland
United States > US
inflammation
post-embolisation syndrome
uterine artery embolization
fibroids
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Summary:Post-embolisation syndrome (PES) is a prevalent complication that occurs in patients following uterine artery embolisation (UAE) for the treatment of uterine fibroids. The aetiology of PES remains incompletely understood, although postulated to result secondary to tissue infarction resulting in release of inflammatory mediators. We followed PRISMA guidelines and performed a systematic review of studies of PES following UAE from inception to October 2022. Our published protocol was prospectively registered. Our search yielded 54 results. We reviewed 22 full texts, and nine articles were included. Observational studies comprised 6/9 relevant studies, with 5/9 retrospective design. The rate of PES was documented in 5/8 studies (excluding case report) with a reported incidence ranging from 4-34.6%. Five of the nine studies studies postulated that the aetiological basis of PES is inflammatory related. Further research is necessary to advance our understanding of PES to define the biological basis of the syndrome with more certainty and gain a consensus on peri-procedure management to reduce incidence and improve patient outcomes.
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ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics12122916