Embolization of a Large Uterine Fibroid

By Antonio Rampoldi, MD, and Carmelo Migliorisi, MD
 

CASE PRESENTATION

A 48-year-old woman presented to our institution with a history of uterine fibroid treated with high-intensity focused ultrasound.

MRI showed three fibroids, including a larger one with intramural measurements of 46 X 50 X 43 mm (Figure 1). Because of some anatomic complications from the last high-intensity focused ultrasound treatment, the patient was a candidate for uterine fibroid embolization.

PROCEDURE DESCRIPTION

From a right femoral approach, we catheterized the left uterine artery. Angiographic evaluation showed no abnormal patterns (Figure 2). Due to a clear vaginal artery, we chose not to intervene.

The right side evaluation, however, showed an abnormal pattern related to the larger fibroid (Figure 3). We chose a 0.021-inch (0.53-mm) 2.4-F (0.8-mm) Direxion™ Torqueable Microcatheter with the capacity to inject large particles with a good overall flow rate, great control, and navigability. We used one 2-mL syringe of 500-μm Embozene™ Microspheres to embolize any feeding vessel of the fibroid.

Figure 1.

Figure 2.

Figure 3.

Figure 4.

FOLLOW-UP AND DISCUSSION

The treatment was successfully performed and the embolization was completed with good fibroid exclusion. Final angiography confirmed exclusion of the fibroid and preservation of tissue vascularization (Figure 4).

Antonio Rampoldi, MD
Chief of Interventional Radiology
Niguarda Ca’ Granda Hospital
Milan, Italy
Disclosures: None.

Carmelo Migliorisi, MD
Interventional Radiologist
Niguarda Ca’ Granda Hospital
Milan, Italy
Disclosures: None.

 

Contact Info

For advertising rates and opportunities, contact:
Craig McChesney
484-581-1816
cmcchesney@bmctoday.com

Stephen Hoerst
484-581-1817
shoerst@bmctoday.com

Charles Philip
484-581-1873
cphillip@bmctoday.com

About Endovascular Today

Endovascular Today is a publication dedicated to bringing you comprehensive coverage of all the latest technology, techniques, and developments in the endovascular field. Our Editorial Advisory Board is composed of the top endovascular specialists, including interventional cardiologists, interventional radiologists, vascular surgeons, neurologists, and vascular medicine practitioners, and our publication is read by an audience of more than 22,000 members of the endovascular community.