Uterine Artery Embolization

Uterine Artery Embolization

Uterine Fibroids

Uterine fibroids are benign tumors of the uterus that often appear in healthy women during childbearing years. Also called leiomyomas or myomas, uterine fibroids are noncancerous growths that can cause debilitating symptoms. Uterine fibroids develop from the smooth muscular tissue of the uterus (myometrium). A single cell divides repeatedly, eventually creating a firm, rubbery mass with a rich blood supply that is distinct from nearby tissue. The growth patterns of uterine fibroids vary — they may grow slowly or rapidly, or they may remain the same size. Uterine fibroids are sensitive to a woman’s hormones. They tend to grow during childbearing years and diminish in size with onset of menopause. Fibroids may even expand during pregnancy and disappear after pregnancy as the uterus goes back to normal size. As many as 3 out of 4 women will have uterine fibroids during their lives. Most women are unaware of them, because they often have no symptoms. Once symptomatic, fibroids can have deleterious effects on a woman’s health and lifestyle.

Symptoms may include severe abdominal pain, pelvic pressure, urinary frequency, constipation, pain with intercourse (dyspareunia), severe anemia from frequent bleeding requiring blood transfusions, and can affect a woman’s ability to conceive a child or have a normal pregnancy.

Uterine Fibroid Treatment

Traditional treatment of fibroids has involved surgery such as Myomectomy and Hysterectomy. Myomectomy is the surgical removal of fibroids
from the wall of the uterus. Hysterectomy is the complete surgical removal of the uterus. Surgery can involve risks such as adverse reactions to
anesthesia, blood loss, physical trauma, and infection. Recovery time is longer with surgical therapies.

Uterine Artery Embolization (UAE) is a minimally invasive procedure that shrinks fibroids by depriving them of blood and nutrients that allow them to grow. In addition, UAE allows preservation of the uterus. Recovery from this minimally invasive procedure is shorter, allowing return to work and usual activities within a few days.

Uterine Artery Embolization

Uterine artery embolization, also known as uterine fibroid embolization (UFE), involves the placement of a small catheter into the uterine artery and
delivery of small particles to starve the blood supply to the fibroid. Uterine artery embolization (UAE) is indicated for relief of bothersome, bulk-related symptoms and abnormal uterine bleeding, also known as menorrhagia. Fibroid size, number, and location are the potential predictors of symptom relief and success of UAE.

The procedure is performed under sedation with local anesthesia. Access is commonly through the radial or femoral artery via the wrist or groin,
respectively. The artery is accessed by a needle puncture. An access catheter is then introduced into the artery. In order to select the uterine vessels
for subsequent embolization, a guiding catheter is placed into the uterine artery under x-ray fluoroscopy guidance. Once at the level of the uterine artery, an angiogram with contrast is performed to confirm placement of the catheter and tiny particles are injected. The particles will follow the direction of blood flow to the fibroids until blood flow to the fibroid slows significantly or ceases altogether. This interruption of blood supply to the fibroids will cause them to shrink over time. The blood supply to the remaining healthy part of the uterus is not affected. UAE has satisfaction rates similar to hysterectomy in relation to symptom relief and offers much shorter recovery times. UAE can also be used to control heavy uterine bleeding for reasons other than fibroids, such as postpartum obstetrical hemorrhage and adenomyosis.

For more information about the Uterine Artery Embolization procedure at Good Samaritan Hospital call (213) 977-2239.

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