What is the most common cause of death after uterine artery embolization (UAE)?

The most common cause of death after uterine artery embolization (UAE) is septicemia resulting from necrotic fibroids. After UAE, the blood supply to the fibroids is compromised, which can lead to tissue ischemia and subsequent necrosis. This necrotic tissue can then become a nidus for infection, potentially leading to septicemia.

Septicemia is a serious condition that occurs when infection spreads into the bloodstream. In the context of UAE, if proper infection control measures are not followed, the risk of developing sepsis from necrotic fibroids increases. This complication underscores the importance of monitoring for signs of infection and managing any postoperative symptoms diligently.

While hemorrhage from fibroids and potential allergic reactions to embolization materials could be concerns during or after the procedure, they are not as commonly associated with mortality as septicemia from necrotic fibroids. Cardiac arrest, although a possible risk during procedural sedation and interventions, is less common compared to the complications arising from tissue necrosis and infection. Therefore, recognizing septicemia as a significant risk factor helps guide both preoperative counseling and postoperative surveillance in patients undergoing UAE.