Uterine fibroid embolization (UFE) in the treatment of severe anemization after methrorragy

Pelvic MRI

A 41-year old female patient was admitted to the Gynecology Department for anemization, due to massive and prolonged methrorragy.

Pelvic MRI showed multiple fibroids of the uterus, measuring from 3 to 7 cm, either transmural or submucosal, with homogeneous contrast enhancement. Gynecologist and IR agreed on Uterine Fibroid Embolization (UFE).

 First Treatment

A torqueable Direxion™ Bern-Shape was chosen and successfully navigated through the winding left uterine artery. The distal part of the vessel was catheterized without causing any arterial spasm.

Contour particles (500-700 micron) were used to perform the embolization.

At selective angiography of the proximal left uterine artery, complete embolization of the fibroids were proved, saving patency of the residual branches of the pelvic floor.

Second Treatment

As in  the left side, a torqueable Bern-shape Direxion was chosen and successfully navigated through the winding right uterine artery.

The distal part of the vessel was easily catheterized. Contour particles (500-700 micron) were used to perform the embolization.

Selective angiography of the proximal right uterine artery showed complete occlusion of the uterine artery with patency of the other branches of the pelvic floor.

Result

Pelvic MRI, performed 3 months  after the embolization, showed complete devascularization of the fibroids.

Average fibroid size decreased on both sides.

Miometrium signal and enhancement was conserved. Hemoglobin values increased 2 months after the procedure and methrorragy was significantly improved

Study and images courtesy of
Dr. Maria Silvia GiulianiDr. Francesco Colucci  -  Interventional Radiologists - "San Camillo Hospital" – Rome
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