*2.1.7.2 Clinical efficacy evaluation*

*Endometriosis*

and local bladder necrosis may occur.

also last for months.

have children.

*2.1.7.1 Follow-up time*

observed without treatment.

increased compared with hysterectomy [9].

CA125 level in patients with adenomyosis.

*2.1.7 Follow-up time and efficacy evaluation after UAE treatment*

After UAE treatment, reexamination assessment is required at 1, 3, and 6 months, and once a year thereafter. The contents of follow-up included change of lesion size, menstruation, sex hormone level, change of dysmenorrhea degree, and

4.Misthrombosis of blood vessels: because the anterior trunk of the internal iliac artery not only gives off the uterine artery but also the bladder artery, vaginal artery, and internal pudendal artery, when the iliac artery and the above arteries are misembolized, complications such as labia majora and minora necrosis

5.Infection: the operation of UAE is a type I incision, and incision infection is rare, mainly necrosis of the lesion after embolization, forming aseptic inflammation. After uterine artery interventional therapy, uterine ischemic focus atrophied and vaginal secretion increased. At that time, the uterus is prone to secondary bacterial infection, and in the worst case, hysterectomy is needed to control sepsis. Intrauterine adhesions can be seen in long-term complications.

7.Bloody vaginal discharge: usually within 2 weeks, a very small number may

8.Oligomenorrhea: after surgery, some patients have partial endometrial necrosis due to uterine artery vascular network embolization, and menstrual volume may be significantly reduced, but hormone examination shows no significant abnormality. If there is no fertility requirement, this part of patients can be

9.Amenorrhea: it is a long-term complication of UAE and is divided into ovarian amenorrhea and uterine amenorrhea. Ovarian amenorrhea is mainly caused by ovarian ischemia and necrosis due to blocking of blood flow in the arteries supplying the ovary, such as the ovarian branch of the uterine artery or the ovarian artery and amenorrhea due to ovarian failure, requiring long-term oral administration of hormone drugs to maintain the level of hormones in the body. Uterine amenorrhea is caused by endometrial ischemic necrosis and impaired endometrial growth, which does not affect hormone secretion and can be observed, but the patient is unable to

10.Others: other serious complications are rare. The incidence of venous thromboembolic complications is approximately 0.4%. Rare complications such as fatal sepsis, femoral nerve injury, iliac artery embolism, uterine ischemic infarction, labia majora and minora necrosis, local bladder necrosis, vesicouterine fistula, uterine wall injury, and necrosis of both toes or heels due to extravasation of embolic agents associated with the UAE procedure also occur. Readmission was required in 2.4 to 3.5% of patients and unplanned surgery in 1.0 to 2.5% of patients. However, overall mortality from UAE was not

6.Allergic reactions or rashes: anti-allergic treatment may be given.

**110**

A large number of clinical trial data [11, 12] showed that 97–100% of patients could tolerate and complete the operation, 77–97.4% of patients had improvement of dysmenorrhea symptoms, and amenorrhea happens occasionally. About 20% of patients need operation or second UAE because of unsatisfactory effect or recurrence of symptoms.
