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Embolization of a Large Uterine Fibroid

By Antonio Rampoldi, MD, and Carmelo Migliorisi, MD


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.


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.

Figure 1.

Figure 2.

Figure 3.

Figure 4.

The right side evaluation, however, showed an abnormal pattern related to the larger fibroid (Figure 3). We chose a 0.021-inch, 2.4-F Direxion™ Torqueable Microcather 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.


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).

Results from case studies are not necessarily predictive of results in other cases. Results in other cases may vary. 

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.


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