Uterine Fibroid Embolisation (UFE)
James Lyon, MD
Sharp Memorial Hospital, San Diego, USA
Patient History
- 48-year-old female with 3-year history of menorrhagia with symptomatic fibroids.
- Hysteroscopic resection of a submucosal fibroid attempted but unsuccessful.
Pre-aortogram
Procedure
- UFE performed using a 6Fr sheath introduced into the right common femoral artery.
- Initial aortogram performed assessing traditional supply to the fibroids.
- A 5Fr Cobra 2 Glidecath was advanced over the aortic bifurcation into the left hypogastric artery.
- The uterine artery was catheterised to its distal ascending segment using a .014” wire and microcatheter.
- Angiogram confirmed placement of the microcatheter distal to the cervical-vaginal branch and proximal to the first fibroid branch.
- Peri-fibroid plexus vessels were incrementally embolised using a total of 2ml of 500-700μm and 1ml of 700-900μm Bead Block microspheres until complete occlusion.
- The right hypogastric artery was then catheterised and the microcatheter reintroduced into the right uterine artery.
- The right uterine artery was then embolised using 2ml of 500-700μm Bead Block microspheres until complete occlusion.
Outcome
- Final aortogram confirmed devascularisation without anomalous arterial blood supply.
Pre-embolisation: left uterine artery
Pre-embolisation: right uterine artery
Post-embolisation: left uterine artery
Post-embolisation: right uterine artery
Post-aortogram