Markers of muscle ischemia, necrosis, and inflammation following uterine artery embolization in the treatment of symptomatic uterine fibroids

Am J Obstet Gynecol. 2007 Mar;196(3):213.e1-5. doi: 10.1016/j.ajog.2006.10.888.

Abstract

Objective: The objective of the study was to quantify markers of myometrial ischemia, necrosis, and inflammation in women undergoing uterine artery embolization (UAE).

Study design: Women with symptomatic fibroids were randomized to treatment with UAE (n = 14) or abdominal myomectomy (n = 11). Peripheral venous blood samples were taken before and after the procedure, at 24 hours and 6 weeks. Creatine kinase (CK) and ischemia-modified albumin (IMA) were measured as markers of necrosis and ischemia. Inflammation was assessed by measurement of C-reactive protein (CRP).

Outcome measures: Changes in the markers following UAE and myomectomy were measured.

Results: Following UAE, no change was seen in CK or IMA, but CRP was raised only at 6 weeks. At 24 hours after myomectomy, there were significant rises in all 3 markers, with a return to normal by 6 weeks.

Conclusion: No significant ischemia or necrosis occurs in the myometrium following UAE, whereas the delayed rise in CRP is likely to reflect necrosis in fibroids.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Biomarkers / blood
  • C-Reactive Protein / analysis*
  • Creatine Kinase / blood*
  • Embolization, Therapeutic / adverse effects*
  • Endometritis / blood*
  • Endometritis / diagnosis*
  • Endometritis / etiology
  • Female
  • Humans
  • Ischemia / blood*
  • Ischemia / diagnosis*
  • Ischemia / etiology
  • Leiomyoma / blood
  • Leiomyoma / blood supply
  • Leiomyoma / surgery
  • Leiomyoma / therapy*
  • Myometrium / blood supply*
  • Myometrium / pathology*
  • Necrosis
  • Serum Albumin / analysis*
  • Uterine Neoplasms / blood
  • Uterine Neoplasms / blood supply
  • Uterine Neoplasms / surgery
  • Uterine Neoplasms / therapy*

Substances

  • Biomarkers
  • Serum Albumin
  • C-Reactive Protein
  • Creatine Kinase