Uterine Artery Embolization: A Growing Pillar of Gynecological Intervention

Author(s): Sunil Balamurugan, Rahul Shah, Kurt Panganiban, Matthew Lehrack, Devendra K. Agrawal.

Uterine Artery Embolization (UAE) is a minimally invasive procedure that has emerged as a transformative option for managing uterine leiomyomas (fibroids), postpartum hemorrhage, and other gynecological conditions. While traditional surgical interventions like hysterectomy and myomectomy remain standard, UAE offers a safer alternative for patients seeking uterine preservation or fertility maintenance. This article examines the efficacy, innovations, and challenges of UAE, with a focus on its expanding applications and implications for patient care. Existing research highlights high success rates of UAE, achieving significant symptom relief in over 90% of cases by occluding uterine arterial blood supply with embolic agents to induce localized ischemia and fibroid necrosis. Innovations in embolic materials, such as hydrophobic injectable liquids, and procedural techniques like transradial access have enhanced safety, reduced complications, and improved patient outcomes. The effectiveness of UAE in treating rarer conditions, including uterine arteriovenous malformations and adenomyosis, demonstrates its versatility. However, questions remain about its long-term reproductive impact, especially concerning fertility outcomes and pregnancy rates, as conflicting data suggest potential risks. This critical review addresses these gaps by synthesizing existing studies to assess comparative efficacy of UAE against surgical options, its safety profile, and its role in advancing minimally invasive gynecology. By exploring both well-established and emerging applications, this article underscores the importance of UAE in reducing morbidity, improving quality of life, and preserving reproductive potential. Further research is essential to refine patient selection criteria, optimize techniques, and better understand the long-term outcomes of the procedure, ensuring UAE continues to evolve as a valuable minimally invasive option within modern gynecological care.