Repeat uterine artery embolization for uterine leiomyomas: Indications, strategies, and outcomes – A case report

Uterine leiomyoma is a frequent cause of abnormal uterine bleeding, especially among African Americans. It is also associated with dysmenorrhea, pelvic pain, infertility, and complicated pregnancies. While hysterectomy and myomectomy are more common forms of treatment for uterine leiomyoma in the United States, uterine artery embolization (UAE) offers a uterus-preserving alternative, with lower rates of major complications, although with an increased risk of reintervention. This case study presents a 45-year-old African American female with persistent abnormal uterine bleeding post-initial UAE, underscoring the importance of strategic techniques during repeat embolization to ensure efficacy. The patient underwent a successful repeat UAE procedure, demonstrating its safety and effectiveness in treating abnormal uterine bleeding while preserving fertility. In this case, the presence of collateral vessels may have contributed to the previous treatment failure. Specific procedural techniques are discussed, and long-term monitoring is recommended for optimal outcomes.