{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T05:08:38Z","timestamp":1784092118334,"version":"3.55.0"},"reference-count":57,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["CVIR Endovasc"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adenomyosis is a benign uterine condition characterized by the presence of glands and endometrial stroma in the myometrium, with hypertrophy of the smooth muscle cells and uterine enlargement, and causing chronic pelvic pain, dysmenorrhea, and abnormal uterine bleeding, resulting in significant impairment of quality of life. In the last decades, the role of interventional radiology has expanded the range of treatment options of this condition, and uterine artery embolization (UAE) has emerged as a minimally invasive therapy in the management of symptomatic adenomyosis. This systematic review aims to evaluate the efficacy and safety of UAE in patients with symptomatic adenomyosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature search was conducted across PubMed, Embase, Cochrane Library, Google Scholar, and Medline database, including studies published up to December 2025. Eligible articles included prospective and retrospective observational cohort studies with more than ten patients reporting UAE outcomes for adenomyosis; case report, case series, narrative or systematic review, meta-analysis, and guidelines were considered as not eligible and were therefore excluded. The data analyzed included patient characteristics, technical and clinical success, symptom improvement, imaging outcomes, reintervention rate, and complications, the latter classified according to the new modified CIRSE classification grading system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-two studies met the inclusion criteria and we collected data on 1701 patients who underwent uterine embolization for therapy-resistant adenomyosis. UAE has\u00a0demonstrated high technical success rates across studies with 1301\/1701 (76.4%) patients experienced significant improvement in heavy menstrual bleeding, dysmenorrhea, and bulky-related symptoms at short- and mid-term follow-up. Imaging assessments showed reductions in uterine volume and junctional zone thickness; reintervention and hysterectomy rates were low. Reported complications were predominantly minor, with a low incidence of major adverse events. The mortality rate post-procedure was 0%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Based on available literature, UAE represents a safe and effective uterus-preserving minimally invasive treatment for selected patients with symptomatic adenomyosis; it represents a step on the treatment pathway before hysterectomy, and women should have access to consult with interventional radiologists when making any treatment decision, in order to achieve a personalized treatment plan.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s42155-026-00727-2","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T04:12:18Z","timestamp":1784088738000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Uterine artery embolization for the treatment of symptomatic adenomyosis: a systematic review"],"prefix":"10.1186","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7529-2680","authenticated-orcid":false,"given":"Corrado","family":"Ini\u2019","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Concetta","family":"Timpanaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro Valerio","family":"Foti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Tiralongo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato","family":"Farina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Libra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide Giuseppe","family":"Castiglione","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Vacirca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Milazzotto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrado","family":"Spatola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Chiara","family":"Lo Greco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Messina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"David","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Palmucci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Basile","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"issue":"6","key":"727_CR1","doi-asserted-by":"publisher","first-page":"1086","DOI":"10.1093\/humupd\/dmab017","volume":"27","author":"SE Bulun","year":"2021","unstructured":"Bulun SE, Yildiz S, Adli M, Wei JJ. Adenomyosis pathogenesis: insights from next-generation sequencing. Hum Reprod Update. 2021;27(6):1086\u201397.","journal-title":"Hum Reprod Update"},{"issue":"4","key":"727_CR2","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1007\/s00404-014-3498-8","volume":"291","author":"M Genc","year":"2015","unstructured":"Genc M, Genc B, Cengiz H. Adenomyosis and accompanying gynecological pathologies. Arch Gynecol Obstet. 2015;291(4):877\u201381.","journal-title":"Arch Gynecol Obstet"},{"issue":"1","key":"727_CR3","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.diii.2012.10.012","volume":"94","author":"G Levy","year":"2013","unstructured":"Levy G, Dehaene A, Laurent N, Lernout M, Collinet P, Lucot JP, et al. An update on adenomyosis. Diagn Interv Imaging. 2013;94(1):3\u201325.","journal-title":"Diagn Interv Imaging"},{"issue":"9","key":"727_CR4","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1055\/s-0033-1350840","volume":"73","author":"F Taran","year":"2013","unstructured":"Taran F, Stewart E, Brucker S. Adenomyosis: epidemiology, risk factors, clinical phenotype and surgical and interventional alternatives to hysterectomy. Geburtshilfe Frauenheilkd. 2013;73(9):924\u201331.","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"727_CR5","doi-asserted-by":"publisher","first-page":"283","DOI":"10.12688\/f1000research.17242.1","volume":"8","author":"S Vannuccini","year":"2019","unstructured":"Vannuccini S, Petraglia F. Recent advances in understanding and managing adenomyosis. F1000Res. 2019;8:283.","journal-title":"F1000Res"},{"issue":"2\u201303","key":"727_CR6","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1055\/s-0040-1716687","volume":"38","author":"J Zhai","year":"2020","unstructured":"Zhai J, Vannuccini S, Petraglia F, Giudice LC. Adenomyosis: mechanisms and pathogenesis. Semin Reprod Med. 2020;38(2\u201303):129\u201343. https:\/\/doi.org\/10.1055\/s-0040-1716687.","journal-title":"Semin Reprod Med"},{"issue":"2\u201303","key":"727_CR7","first-page":"89","volume":"38","author":"K Upson","year":"2020","unstructured":"Upson K, Missmer SA. Epidemiology of adenomyosis. Semin Reprod Med. 2020;38(2\u201303):89\u2013107.","journal-title":"Semin Reprod Med"},{"key":"727_CR8","doi-asserted-by":"publisher","unstructured":"Abbott JA. Adenomyosis and abnormal uterine bleeding (AUB-A)-pathogenesis, diagnosis, and management. Best Pract Res Clin Obstet Gynaecol. 2017;40:68\u201381. https:\/\/doi.org\/10.1016\/j.bpobgyn.2016.09.006.","DOI":"10.1016\/j.bpobgyn.2016.09.006"},{"issue":"1","key":"727_CR9","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1148\/rg.251045060","volume":"25","author":"K Tamai","year":"2005","unstructured":"Tamai K, Togashi K, Ito T, Morisawa N, Fujiwara T, Koyama T. MR imaging findings of adenomyosis: correlation with histopathologic features and diagnostic pitfalls. Radiographics. 2005;25(1):21\u201340. https:\/\/doi.org\/10.1148\/rg.251045060.","journal-title":"Radiographics"},{"key":"727_CR10","doi-asserted-by":"publisher","unstructured":"Andres MP, Borrelli GM, Ribeiro J, Baracat EC, Abr\u00e3o MS, Kho RM. Transvaginal ultrasound for the diagnosis of adenomyosis: systematic review and meta-analysis. J Minim Invasive Gynecol. 2018;25(2):257\u201364. https:\/\/doi.org\/10.1016\/j.jmig.2017.08.653.","DOI":"10.1016\/j.jmig.2017.08.653"},{"key":"727_CR11","doi-asserted-by":"publisher","first-page":"2427","DOI":"10.1093\/humrep\/16.11.2427","volume":"16","author":"M Bazot","year":"2001","unstructured":"Bazot M, Cortez A, Darai E, et al. Ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology. Hum Reprod. 2001;16:2427\u201333.","journal-title":"Hum Reprod"},{"key":"727_CR12","doi-asserted-by":"publisher","first-page":"345","DOI":"10.7863\/jum.1987.6.7.345","volume":"6","author":"D Siedler","year":"1987","unstructured":"Siedler D, Laing FC, Jeffrey RB Jr, Wing VW. Uterine adenomyosis: a difficult sonographic diagnosis. J Ultrasound Med. 1987;6:345\u20139.","journal-title":"J Ultrasound Med"},{"key":"727_CR13","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1148\/radiology.190.3.8115630","volume":"190","author":"SM Ascher","year":"1994","unstructured":"Ascher SM, Arnold LL, Patt RH, et al. Adenomyosis: prospective comparison of MR imaging and transvaginal sonography. Radiology. 1994;190:803\u20136.","journal-title":"Radiology"},{"issue":"151\u2013158","key":"727_CR14","first-page":"7","volume":"199","author":"C Reinhold","year":"1996","unstructured":"Reinhold C, McCarthy S, Bret PM, et al. Diffuse adenomyosis: comparison of endovaginal US and MR imaging with histopathologic correlation. Radiology. 1996;199(151\u2013158):7.","journal-title":"Radiology"},{"key":"727_CR15","doi-asserted-by":"crossref","unstructured":"Hamm B, Forstner R. MRI and CT of the female pelvis. 2006. ISBN: 9783540222897 - Google Books.","DOI":"10.1007\/978-3-540-68212-7"},{"issue":"2","key":"727_CR16","doi-asserted-by":"publisher","first-page":"1724","DOI":"10.1111\/jcmm.14866","volume":"24","author":"X Che","year":"2020","unstructured":"Che X, Wang J, He J, et al. A new trick for an old dog: the application of mifepristone in the treatment of adenomyosis. J Cell Mol Med. 2020;24(2):1724\u201337.","journal-title":"J Cell Mol Med"},{"key":"727_CR17","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.bpobgyn.2017.09.003","volume":"46","author":"JJ Keung","year":"2018","unstructured":"Keung JJ, Spies JB, Caridi TM. Uterine artery embolization: a review of current concepts. Best Pract Res Clin Obstet Gynecol. 2018;46:66\u201373.","journal-title":"Best Pract Res Clin Obstet Gynecol"},{"key":"727_CR18","doi-asserted-by":"publisher","DOI":"10.1016\/j.tvir.2021.100726","volume":"24","author":"TM Caridi","year":"2021","unstructured":"Caridi TM. Uterine artery embolization for adenomyosis. Tech Vasc Interv Radiol. 2021;24:100726.","journal-title":"Tech Vasc Interv Radiol"},{"issue":"4","key":"727_CR19","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1016\/j.jvir.2012.12.002","volume":"24","author":"GR Kaump","year":"2013","unstructured":"Kaump GR, Spies JB. The impact of uterine artery embolization on ovarian function. J Vasc Interv Radiol. 2013;24(4):459\u201367. https:\/\/doi.org\/10.1016\/j.jvir.2012.12.002.","journal-title":"J Vasc Interv Radiol"},{"issue":"1","key":"727_CR20","doi-asserted-by":"publisher","first-page":"1178","DOI":"10.1186\/s12884-025-08323-3","volume":"25","author":"L Liu","year":"2025","unstructured":"Liu L, Wang T, Li Y, Tian H, Zhou C, Cai W. Reproductive outcomes after fertility-sparing interventions for symptomatic adenomyosis: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2025;25(1):1178. https:\/\/doi.org\/10.1186\/s12884-025-08323-3.","journal-title":"BMC Pregnancy Childbirth"},{"key":"727_CR21","doi-asserted-by":"publisher","unstructured":"Manyonda I, Belli AM, Lumsden MA, Moss J, McKinnon W, Middleton LJ, et al. Uterine-artery embolization or myomectomy for uterine fibroids. N Engl J Med. 2020;383(5):440\u2013451. https:\/\/doi.org\/10.1056\/NEJMoa1914735.","DOI":"10.1056\/NEJMoa1914735"},{"key":"727_CR22","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.bpobgyn.2018.01.016","volume":"51","author":"M Dueholm","year":"2018","unstructured":"Dueholm M. Minimally invasive treatment of adenomyosis. Best Pract Res Clin Obstet Gynecol. 2018;51:119\u201337.","journal-title":"Best Pract Res Clin Obstet Gynecol"},{"key":"727_CR23","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1007\/s00270-025-04200-w","volume":"49","author":"D Filippiadis","year":"2026","unstructured":"Filippiadis D, Pereira PL, Hausegger KA, et al. CIRSE standards of practice for the classification of complications: the modified CIRSE classification system. Cardiovasc Intervent Radiol. 2026;49:2\u20136.","journal-title":"Cardiovasc Intervent Radiol"},{"key":"727_CR24","doi-asserted-by":"crossref","unstructured":"Rayyan Systems Inc. Rayyan. Available from https:\/\/www.rayyan.ai.\u00a0Cited 2025 Feb 20.","DOI":"10.5339\/jist.2025.15"},{"issue":"1","key":"727_CR25","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1016\/j.ejrad.2007.12.009","volume":"70","author":"MJ Bratby","year":"2009","unstructured":"Bratby MJ, Walker WJ. Uterine artery embolisation for symptomatic adenomyosis\u2013mid-term results. Eur J Radiol. 2009;70(1):128\u201332.","journal-title":"Eur J Radiol"},{"key":"727_CR26","doi-asserted-by":"crossref","unstructured":"De Bruijn AM, Smink M, Hehenkamp WJK, et al. Uterine artery embolization for symptomatic adenomyosis: 7-year clinical follow-up using UFS-Qol questionnaire. Cardiovasc Intervent Radiol. 2017;40(9):1344\u201350.","DOI":"10.1007\/s00270-017-1686-1"},{"issue":"3","key":"727_CR27","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1007\/s00270-011-0254-3","volume":"35","author":"V Froeling","year":"2012","unstructured":"Froeling V, Scheurig-Muenkler C, Hamm B, Kroencke TJ. Uterine artery embolization to treat uterine adenomyosis with or without uterine leiomyomata: results of symptom control and health-related quality of life 40 months after treatment. Cardiovasc Intervent Radiol. 2012;35(3):523\u20139.","journal-title":"Cardiovasc Intervent Radiol"},{"issue":"6","key":"727_CR28","doi-asserted-by":"publisher","first-page":"1252","DOI":"10.1007\/s11596-021-2473-4","volume":"41","author":"WB Guo","year":"2021","unstructured":"Guo WB, Hu SQ, Wan TT, Wu ZQ, Chen S, Yang JY. Preoperative MRI classification may not predict symptom relief after uterine artery embolization in patients with adenomyosis. Curr Med Sci. 2021;41(6):1252\u20136.","journal-title":"Curr Med Sci"},{"issue":"1","key":"727_CR29","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2024.2372645","volume":"44","author":"S Hu","year":"2024","unstructured":"Hu S, Guo W, Chen S, et al. Factors associated with dysmenorrhoea and menorrhagia improvement in patients with adenomyosis after uterine artery embolisation. J Obstet Gynaecol. 2024;44(1):2372645.","journal-title":"J Obstet Gynaecol"},{"issue":"1","key":"727_CR30","doi-asserted-by":"publisher","first-page":"176","DOI":"10.2214\/AJR.05.1613","volume":"188","author":"MD Kim","year":"2007","unstructured":"Kim MD, Kim S, Kim NK, et al. Long-term results of uterine artery embolization for symptomatic adenomyosis. AJR Am J Roentgenol. 2007;188(1):176\u201381.","journal-title":"AJR Am J Roentgenol"},{"issue":"4","key":"727_CR31","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/j.jvir.2011.01.426","volume":"22","author":"MD Kim","year":"2011","unstructured":"Kim MD, Kim YM, Kim HC, et al. Uterine artery embolization for symptomatic adenomyosis: a new technical development of the 1-2-3 protocol and predictive factors of MR imaging affecting outcomes. J Vasc Interv Radiol. 2011;22(4):497\u2013502.","journal-title":"J Vasc Interv Radiol"},{"issue":"3","key":"727_CR32","doi-asserted-by":"publisher","first-page":"855","DOI":"10.2214\/AJR.04.1661","volume":"186","author":"Y Kitamura","year":"2006","unstructured":"Kitamura Y, Allison SJ, Jha RC, Spies JB, Flick PA, Ascher SM. MRI of adenomyosis: changes with uterine artery embolization. AJR Am J Roentgenol. 2006;186(3):855\u201364.","journal-title":"AJR Am J Roentgenol"},{"issue":"4","key":"727_CR33","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1111\/ajo.12767","volume":"58","author":"E Liang","year":"2018","unstructured":"Liang E, Brown B, Rachinsky M. A clinical audit on the efficacy and safety of uterine artery embolisation for symptomatic adenomyosis: results in 117 women. Aust N Z J Obstet Gynaecol. 2018;58(4):454\u20139.","journal-title":"Aust N Z J Obstet Gynaecol"},{"issue":"4","key":"727_CR34","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1016\/j.jvir.2024.12.001","volume":"36","author":"S Manduca","year":"2025","unstructured":"Manduca S, Mabud T, Liu S, Morris E, Taslakian B, Kulkarni K. Uterine artery embolization for mixed adenomyosis and fibroids: outcomes according to initial particle sizes. J Vasc Interv Radiol. 2025;36(4):608\u201315.","journal-title":"J Vasc Interv Radiol"},{"key":"727_CR35","doi-asserted-by":"publisher","first-page":"3788","DOI":"10.3390\/jcm14113788","volume":"14","author":"MI Mitranovici","year":"2025","unstructured":"Mitranovici MI, Costachescu D, Dumitrascu-Biris D, et al. Uterine artery embolization as an alternative therapeutic option in adenomyosis: an observational retrospective single-center study. J Clin Med. 2025;14:3788.","journal-title":"J Clin Med"},{"issue":"1","key":"727_CR36","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1007\/s00270-014-0878-1","volume":"38","author":"RJ Nijenhuis","year":"2015","unstructured":"Nijenhuis RJ, Smeets AJ, Morpurgo M, et al. Uterine artery embolisation for symptomatic adenomyosis with polyzene F-coated hydrogel microspheres: three-year clinical follow-up using UFS-QoL questionnaire. Cardiovasc Intervent Radiol. 2015;38(1):65\u201371.","journal-title":"Cardiovasc Intervent Radiol"},{"issue":"3","key":"727_CR37","doi-asserted-by":"publisher","first-page":"948","DOI":"10.1148\/radiol.2343031697","volume":"234","author":"JP Pelage","year":"2005","unstructured":"Pelage JP, Jacob D, Fazel A, Namur J, Laurent A, Rymer R, et al. Midterm results of uterine artery embolization for symptomatic adenomyosis: initial experience. Radiology. 2005;234(3):948\u201353.","journal-title":"Radiology"},{"key":"727_CR38","doi-asserted-by":"crossref","unstructured":"Siskin GP, Tublin ME, Stainken BF, Dowling K, Dolen EG. Uterine artery embolization for the treatment of adenomyosis: clinical response and evaluation with MR imaging. AJR Am J Roentgenol. 2001;177(2):297\u2013302.","DOI":"10.2214\/ajr.177.2.1770297"},{"issue":"4","key":"727_CR39","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1007\/s00270-011-0203-1","volume":"35","author":"AJ Smeets","year":"2012","unstructured":"Smeets AJ, Nijenhuis RJ, Boekkooi PF, Vervest HA, van Rooij WJ, Lohle PN. Long-term follow-up of uterine artery embolization for symptomatic adenomyosis. Cardiovasc Intervent Radiol. 2012;35(4):815\u20139.","journal-title":"Cardiovasc Intervent Radiol"},{"issue":"8","key":"727_CR40","doi-asserted-by":"publisher","first-page":"1558","DOI":"10.1111\/aogs.15165","volume":"104","author":"LM Trommelen","year":"2025","unstructured":"Trommelen LM, Semmler A, de Bruijn AM, et al. Quality of life 1 year after uterine artery embolization vs hysterectomy for symptomatic adenomyosis (QUESTA study). Acta Obstet Gynecol Scand. 2025;104(8):1558\u201374.","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"1","key":"727_CR41","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1186\/s42155-024-00468-0","volume":"7","author":"K Turt\u00f3czki","year":"2024","unstructured":"Turt\u00f3czki K, Cho H, Dastaran S, Kaposi PN, T\u00f6m\u00f6sv\u00e1ry Z, V\u00e1rb\u00edr\u00f3 S, et al. Evaluation of junctional zone differential and ratio as possible markers of clinical efficacy in uterine artery embolisation of adenomyosis. CVIR Endovasc. 2024;7(1):55.","journal-title":"CVIR Endovasc"},{"issue":"2","key":"727_CR42","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1016\/j.ijgo.2015.09.016","volume":"133","author":"S Wang","year":"2016","unstructured":"Wang S, Meng X, Dong Y. The evaluation of uterine artery embolization as a nonsurgical treatment option for adenomyosis. Int J Gynaecol Obstet. 2016;133(2):202\u20135.","journal-title":"Int J Gynaecol Obstet"},{"issue":"5","key":"727_CR43","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1007\/s11547-020-01136-8","volume":"125","author":"Y Wang","year":"2020","unstructured":"Wang Y, Lyu W, Xu W, Yu Y. Asherman syndrome in adenomyosis treated with uterine artery embolization: incidence predictive factors. Radiol Med. 2020;125(5):437\u201343.","journal-title":"Radiol Med"},{"issue":"1","key":"727_CR44","doi-asserted-by":"publisher","first-page":"6027","DOI":"10.1038\/s41598-025-85823-4","volume":"15","author":"WJ Wei","year":"2025","unstructured":"Wei WJ, Tian ZF, Liu H, Xiao CJ. The clinical efficacy and influencing factors of uterine artery embolization in the treatment of different types of uterine adenomyosis. Sci Rep. 2025;15(1):6027.","journal-title":"Sci Rep"},{"key":"727_CR45","doi-asserted-by":"publisher","first-page":"3575","DOI":"10.2147\/IJGM.S312618","volume":"14","author":"K Yuan","year":"2021","unstructured":"Yuan K, Zhang JL, Yan JY, et al. Uterine artery embolization with small-sized particles for the treatment of symptomatic adenomyosis: a 42-month clinical follow-up. Int J Gen Med. 2021;14:3575\u201381.","journal-title":"Int J Gen Med"},{"issue":"11","key":"727_CR46","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0165610","volume":"11","author":"J Zhou","year":"2016","unstructured":"Zhou J, He L, Liu P, et al. Outcomes in adenomyosis treated with uterine artery embolization are associated with lesion vascularity: a long-term follow-up study of 252 cases. PLoS ONE. 2016;11(11):e0165610.","journal-title":"PLoS ONE"},{"key":"727_CR47","unstructured":"The Ottawa Hospital Research Institute. Clinical epidemiology: Oxford Centre for Evidence-Based Medicine levels of evidence. Ottawa (ON): OHRI. Available from: https:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp.\u00a0Cited 2026 Jan 20."},{"key":"727_CR48","unstructured":"Cochrane Methods. Risk of bias. London: Cochrane. Available from: https:\/\/methods.cochrane.org\/bias. Cited 2026 Jan 20."},{"key":"727_CR49","doi-asserted-by":"publisher","unstructured":"Boncoraglio A, Caltabiano G, Foti PV, Mammino L, Failla G, Palmucci S, et al. Distal radial artery: the last extreme rescue arterial access for interventional radiologists? SAGE Open Med Case Rep. 2019;7:2050313X18823918. https:\/\/doi.org\/10.1177\/2050313X18823918.","DOI":"10.1177\/2050313X18823918"},{"issue":"5","key":"727_CR50","doi-asserted-by":"publisher","first-page":"663","DOI":"10.21037\/gs-24-118","volume":"13","author":"X Wang","year":"2024","unstructured":"Wang X, Zhang W, Xue S, Lasmar RB, Zhao D, Wang X. Efficacy and safety of uterine artery embolization via the distal radial approach for uterine fibroids or adenomyosis: a single-center retrospective cohort study. Gland Surg. 2024;13(5):663\u20138. https:\/\/doi.org\/10.21037\/gs-24-118.","journal-title":"Gland Surg"},{"issue":"3","key":"727_CR51","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1016\/S0015-0282(97)00245-8","volume":"68","author":"L Fedele","year":"1997","unstructured":"Fedele L, Bianchi S, Raffaelli R, Portuese A, Dorta M. Treatment of adenomyosis-associated menorrhagia with a levonorgestrel-releasing intrauterine device. Fertil Steril. 1997;68(3):426\u20139.","journal-title":"Fertil Steril"},{"key":"727_CR52","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1186\/s13244-019-0732-8","volume":"10","author":"R Dessouky","year":"2019","unstructured":"Dessouky R, Gamil SA, Nada MG, et al. Management of uterine adenomyosis: current trends and uterine artery embolization as a potential alternative to hysterectomy. Insights Imaging. 2019;10:48.","journal-title":"Insights Imaging"},{"issue":"6","key":"727_CR53","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1016\/j.jvir.2013.02.034","volume":"24","author":"SY Kim","year":"2013","unstructured":"Kim SY, Chang CH, Lee JS, Kim YJ, Kim MD, Han DW. Comparison of the efficacy of dexmedetomidine plus fentanyl patient-controlled analgesia with fentanyl patient-controlled analgesia for pain control in uterine artery embolization for symptomatic fibroid tumors or adenomyosis: a prospective, randomized study. J Vasc Interv Radiol. 2013;24(6):779\u201386.","journal-title":"J Vasc Interv Radiol"},{"issue":"4","key":"727_CR54","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1111\/1471-0528.13785","volume":"123","author":"SY Kim","year":"2016","unstructured":"Kim SY, Koo BN, Shin CS, Ban M, Han K, Kim MD. The effects of single-dose dexamethasone on inflammatory response and pain after uterine artery embolisation for symptomatic fibroids or adenomyosis: a randomised controlled study. BJOG. 2016;123(4):580\u20137.","journal-title":"BJOG"},{"issue":"12","key":"727_CR55","doi-asserted-by":"publisher","first-page":"1629","DOI":"10.1016\/j.jvir.2017.07.034","volume":"28","author":"AM De Bruijn","year":"2017","unstructured":"De Bruijn AM, Smink M, Lohle PNM, Huirne JAF, Twisk JWR, Wong C, et al. Uterine artery embolization for the treatment of adenomyosis: a systematic review and meta-analysis. J Vasc Interv Radiol. 2017;28(12):1629-1642.e1.","journal-title":"J Vasc Interv Radiol"},{"key":"727_CR56","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20220121","author":"T Kr\u00f6ncke","year":"2023","unstructured":"Kr\u00f6ncke T. An update on uterine artery embolization for uterine leiomyomata and adenomyosis of the uterus. Br J Radiol. 2023. https:\/\/doi.org\/10.1259\/bjr.20220121.","journal-title":"Br J Radiol"},{"key":"727_CR57","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1007\/s13669-023-00367-6","volume":"12","author":"S Roop","year":"2023","unstructured":"Roop S, Patel S, Zhang M, et al. Uterine artery embolization for adenomyosis: a review of imaging, techniques, complications and outcomes. Curr Obstet Gynecol. 2023;12:186\u201397.","journal-title":"Curr Obstet Gynecol"}],"container-title":["CVIR Endovascular"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42155-026-00727-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s42155-026-00727-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42155-026-00727-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T05:01:30Z","timestamp":1784091690000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s42155-026-00727-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,15]]},"references-count":57,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["727"],"URL":"https:\/\/doi.org\/10.1186\/s42155-026-00727-2","relation":{},"ISSN":["2520-8934"],"issn-type":[{"value":"2520-8934","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,15]]},"assertion":[{"value":"31 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"87"}}