Outcome of trans-radial uterine artery fibroid embolisation: A Kenyan experience

Abstract

Background: The current management practice of fibroids in many local hospitals in Kenya does not routinely include uterine fibroid embolization or interventional radiology consults. This is despite most embolization requests being on an emergency basis for intractable bleeding and patient with low haemoglobin unsuitable for surgery. There is paucity of data regarding the technical success rates and complications associated with trans radial UFE in Kenya despite it being utilised in several facilities in patients with fibroids.
Objective: The study sought to determine the characteristics, technical success rates and complications in patients undergoing TR-UFE at two local hospitals.
Materials and methods: A retrospective and prospective study that included 48 patients in two hospitals was done. UFE was done via TRA, and embolization done using Embospheres 500-700 and 700-900µm. Data such as patient's age, symptomatology, imaging done was extracted from the patients' records.
Results: All 48 patients (100%) had technically successful UFE at the two facilities with mean age of 43.3 (SD= 6.8) years. Half, 24 (50.0%), had anaemia. Only 5 (10.4%) had received prior treatment for the condition. On imaging, the mean number of fibroids was 5.4 (SD=2.8). Complications recorded included pain and cramping, post embolization syndrome. From the trans-radial approach, access site complications included hematoma (3; 6.3%), pain (2;4.2%) and bleeding from the puncture site (1; 2.1%).
Conclusion: The study assessed the technical success rate and complications associated with TRA UFE and found that uterine artery embolization is a viable and successful treatment option for fibroids with few complications.