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An Audit of Uterine Artery Embolisation (UAE) service in a District General Hospital
EP29144
Poster Title: An Audit of Uterine Artery Embolisation (UAE) service in a District General Hospital
Submitted on 14 Sep 2018
Author(s): Riddhika Chakravartty, Alessandro Antonello, Kivraj Sabharwal, Alastair Oakes, Jordan Green, Suzanna Shears-Hutt, Mahalakshmi Gorti, Ajay Pankhania
Affiliations: East Surrey Hospital
Poster Views: 471
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Poster Information
Abstract: Introduction:
UAE has been used for treatment of fibroids in our District General Hospital since 2011. As part of a service improvement project, we audited technical success and outcomes.
Standard:
The Joint Royal College of Obstetricians & Gynaecologists (RCOG) and Royal College of Radiologists (RCR) clinical guideline published in 2013 provides standards for care and expected complication rates.
Cycle 1:
72 patients underwent UAE between November 2011 and December 2015. Technical success rate was 98.6%, with 63% patient satisfaction rate at 6 months. Fibroid volume showed a median 20% reduction at 6 months. Inadequate documentation was a major factor affecting results. Excluding missing data, complication rates were in line with the RCOG/RCR standards. Also highlighted was a poor understanding of post-embolisation syndrome amongst clinical staff.
Intervention:
Creation of a local policy with a standardised clerking proforma and departmental teaching about the UAE procedure and expected complications.
Cycle 2:
54 patients underwent UAE between January 2016 and January 2018. Technical success continued to be high at 98.3% with 74% patient satisfaction rate at 6 months. Median fibroid volume reduction was 26%. Mean post procedure hospital stay reduced to 3 to 2 days. Increased pain relief was prescribed, suggesting a greater awareness of post embolization syndrome. Missing data was considerably reduced including consent, DAP and medication documentation. A formal data base is now being set up to ensure consistent future documentation.
Conclusion:
A UAE service can be effectively and safely delivered in a district general hospital.
Summary: This is the result of a service improvement project to assess the techinical success and complication rate from the Uterine Artery Embolisation Service.References: Gupta JK, Sinha A, Lumsden et al. TI: Uterine artery embolization for symptomatic uterine fibroids. Cochrane Database of Systematic Reviews. 2012, No 5. 
Edwards RD, et al. Uterine artery embolisation versus Surgery for symptomatic fibroids. N Engl J Med 2007; 356(4):360-370. 
Volkers NA, et al. Uterine artery embolisation in the treatment of symptomatic uterine fibroid tumours (EMMY trial): periprocedural results and complications. J Vasc Interv Radiol, 2006;17(3) 471-80. 
Clinical recommendations on the use of uterine artery embolisation (UAE) in the management of fibroids Royal College of Radiologists/Royal College of Obstetricians and Gynaecologists 2013, accessed 30 April 2013 http://www.rcr.ac.uk/docs/radiology/pdf/bfcr(13)_uae_3rd.pdf 
NICE Interventional Procedure Guidance 094, October 2004.

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