Comparison of the transradial and transfemoral approaches for uterine artery embolization: a randomized clinical trial

Background Uterine artery embolization (UAE) is a procedure commonly used to control uterine bleeding or pain. While the procedure is traditionally performed through the transfemoral approach (TFA), the transradial approach (TRA) is another method. Purpose To compare the effectiveness of the UAE using the TRA approach versus the TFA approach. Material and Methods This non-blinded, randomized clinical trial was conducted at a tertiary hospital between 1 January 2019 and 30 June 2022. A total of 42 female patients with abnormal uterine bleeding and/or pelvic pain from uterine fibroids were randomly assigned to either the TRA group or the TFA group. Data collected included demographic information, procedural details, patient satisfaction, and radiation metrics. Results The TRA group had significantly lower numbers of microsphere vials used compared to the TFA group ( P = 0.014). While there were no significant differences in procedure times ( P = 0.058), fluoroscopic times ( P = 0.117), or radiation doses ( P = 0.466), the TRA approach was associated with a higher success rate in achieving bilateral UA catheterization and fewer instances of bilateral sheath insertion. Patient satisfaction scores were similar between the groups, with no statistically significant difference ( P = 0.932). Minor adverse events such as local hematoma and color changes were more frequent in the TFA group, though these differences were not statistically significant. Conclusion Although both approaches were effective for the UAE, the TRA approach may be a viable alternative to the TFA due to its higher success rate in achieving bilateral catheterization, lower radiation doses, and shorter procedural times.