 
|
What is Uterine Fibroid Embolization?
This is a new non-surgical approach to the treatment of fibroids, which is performed by a specially trained radiologist, called an Interventional Radiologist. Interventional Radiologists diagnose and treat numerous conditions that once required surgery including percutaneous (through a nick in the skin) dilatation of narrowed peripheral arteries and veins (angioplasty and stenting), angiographic treatment of bleeding (embolization), opening of clotted blood vessels and dialysis grafts (thrombolysis), placement of central venous access devices and dialysis catheters, performance of a wide variety of male and female infertility procedures, placement of percutaneous feeding tubes, percutaneous needle biopsy procedures of the breast and other tissues, and wide array of other similar procedures.
Uterine fibroid embolization is “minimally invasive” and is performed through a tiny nick in the skin in the groin under local anesthesia where a tiny catheter or tube is placed into the arterial system. The procedure is performed with conscious sedation, which makes the procedure essentially painless. Under fluoroscopic guidance, the radiologist places a tiny catheter into each of the two arteries supplying the uterus, and injects small amounts of embolic particles which closes off blood supply to the uterus and fibroids (see Figures 2 and 3). While embolization to treat uterine fibroids has been performed for more than a decade, embolization of arteries in the uterus is not new. Interventional radiologists have used the procedure successfully for more than 30 years to treat a variety of medical conditions causing heavy vaginal or pelvic bleeding including massive pelvic trauma, post-partum uterine atony, ectopic pregnancy, and advanced gynecologic cancer. There are an estimated 14,000 UFE procedures performed annually in the United States.
| Figure 1 shows a small tube (catheter) placed into the groin and access is gained into the femoral artery. Local anesthesia is used so the needle puncture is not painful. The interventional radiologist steers the catheter through the arteries using x-ray imaging to guide the catheter’s progress. An arteriogram is performed to provide the interventional radiologist with a “map” of the blood supply to the uterus and fibroids. This involves the injection of x-ray contrast media while a series of x-ray images are taken. The catheter is then moved into the uterine artery at a point where it divides into multiple vessels supplying blood to the fibroids. |
 |
 |
Figure 2 shows the catheter tip in the appropriate location in the uterine artery supplying blood to the fibroid. The interventional radiologist then slowly injects tiny embolic particles into the blood vessels. These are the size of tiny grains of sand. Over several minutes, the arteries are slowly blocked. The embolization is continued until there is nearly complete blockage of blood flow in the blood vessel. The procedure is then repeated on the other side of the uterus, but through the same puncture site. After the embolization, another arteriogram is performed to confirm that the results are satisfactory. The skin puncture where the catheter was inserted is cleaned and covered with a bandage. As a result of the reduced blood flow, the fibroids begin to shrink.
|
Other UFE Facts:
- The embolic particles are approved by the FDA specifically for UFE, based on comparative trials showing similar efficacy with less serious complications compared to hysterectomy and myomectomy (the surgical removal of fibroids).
- Embolization of fibroids was first used as an adjunct to help decrease blood loss during myomectomy. To the surprise of the initial users of this method, many patients had spontaneous resolution of their symptoms after only the embolization and no longer needed the surgery.
- UFE is covered by most major insurance companies.
- Most women with symptomatic fibroids are candidates for UFE and should obtain a consult with an interventional radiologist to determine whether UFE is a treatment option for them. An ultrasound or MRI diagnostic test will help the interventional radiologist to determine if the woman is a candidate for this treatment.
- Many women wonder about the safety of leaving particles in the body. The embolic particles most commonly used in UFE have been available with FDA approval for use in a wide variety of procedures in people for more than 20 years. During that time, they have been used in thousands of patients without long-term complications.
|
UFE Main Page