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Uterine Fibroid Embolization Case
 This 39 year old patient had three uterine fibroids ranging in size from 3 cm to 5cm. She suffered from severely painful menstrual cycles with very heavy bleeding. She had recently been diagnosed with anemia which was felt to be due to her heavy menstrual cycles. The first image is a pelvic arteriogram which shows both uterine arteries coursing horizontally toward the middle in the bottom third of the image. The uterine arteries are easily identified by their position and tortuosity. The right uterine artery is the dominant vessel supplying the uterus |
 This is a selective arteriogram of the left uterine artery. The small, feathery branches on the left of the image supply the uterus and fibroids. Note the focal narrowing of the main uterine artery near the tip of the micro-catheter due to spasm. Flow through the uterine artery is often diminished in the setting of spasm which could lead to inadequate embolization. |
 This image was obtained 5 minutes after administering nitroglycerin directly into the uterine artery. Nitroglycerin is a potent vasodilator (blood vessel dilator) which is often used to treat spasm during angiograms. Note that the spasm has resolved. |
 This image was obtained after embolizing the uterine artery with particles. Note the main uterine artery is visualized but the fine, feathery branches are no longer seen. This desired end-point of embolization has been termed "pruning the tree." |
 This image is a selective arteriogram of the right uterine artery. In this patient, it is the dominant artery supplying the uterus. Note that both uterine arteries were catheterized with a single catheter placed through the right groin. |
 This final image is a close-up of the right uterine artery at the conclusion of embolization. Note the pruned tree appearance with the main trunk of the uterine artery still visible and the fine, feathery branches no longer visible. This patient returned to work three days following the procedure and resumed normal menstrual cycles without the painful, heavy flow she had experienced prior to UFE. |
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