Abstract
Patients who have been treated for fibroid disease by embolotherapy occasionally may not experience satisfactory symptom relief. Others, who initially do have relief from their fibroid-related symptoms may have those symptoms recur. Causes for clinical failure and symptom recurrence include incomplete fibroid infarction and interval growth of new fibroids. Many of these patients will respond to repeat embolization.
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Notes
- 1.
The desired endpoint for UAE (Worthington-Kirsch 2011) is angiographic evidence that there has been a change in the flow pattern in the uterus suggesting that the fibroid/uterine vascular bed is largely embolized. These include any of the following findings: (1) Reflux into the ovarian artery that was not present on pre-embolization injection of the uterine artery. (2) Filling of cross-uterine collaterals that were not previously seen. (3) Retrograde flow of contrast in the uterine artery with injection. (4) Transient dilation (“plumping”) of the uterine artery near the catheter tip with injection.
- 2.
The author routinely performs UAE with a 5Fr diagnostic catheter, almost always either a Levin 1 curve or a Roberts Uterine curve. The catheter tip is positioned in the transverse segment of the uterine artery. The author only uses microcatheters in cases where the uterine artery is either too small or too tortuous to be catheterized with the 5Fr catheter.
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Worthington-Kirsch, R.L. (2012). The Role of a Repeat UAE Procedure. In: Reidy, J., Hacking, N., McLucas, B. (eds) Radiological Interventions in Obstetrics and Gynaecology. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2012_595
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DOI: https://doi.org/10.1007/174_2012_595
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