UFE is performed in the angiography suite. The procedure takes about an hour to perform. From the common femoral approach, we map out the arterial anatomy of the uterus, then use selective catheterization to gain safe purchase into the uterine arteries. 

These are evaluated to ensure that embolization is safe (ex: absence of AV fistula or communication with bowel). Typically, a microcatheter is advanced coaxially deep into the uterine artery, past the cervicovaginal branch if possible. 

The artery is embolized with permanent particulate material. We usually use calibrated microspheres of an acrylic called Embospheres, though will on occasion use calibrated spheres of polyvinyl alcohol.

Particles of this size occlude at the arteriolar level but not the capillary level. The abnormal, hypertrophied vessels supplying the fibroids will receive many more of these particles than will the normal uterine branches due to the increased flow. 

I usually embolize the left uterine artery first, then I manipulate the catheters into position to embolize the right uterine artery. The hypervascular fibroids, now devascularized, undergo fibrinoid necrosis. The uterus survives.

Here are pre-embolization and post-embolization arteriograms of the left uterine artery.

Pre-embolization    

Post-embolization 

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For more information, please contact me by e-mail or by phone 210.616.7780.  Or visit the Society of Interventional Radiology's www site and follow the links about UFE.

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This page was last updated onMonday, March 01, 2010

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