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Uterine Artery Embolization has many Indications:-

· Single / multiple Uterine Fibroids.
· Adenomyosis.
· Failed myomectomy / recurrence of fibroids after myomectomy
· High risk patient for surgery like obesity, anemia, Chronic renal failure etc .
· Post-partum Hemorrhage
· Bleeding from Cancer of Cervix & Uterus
· Pre-operative embolization to reduce bleeding during uterine surgery.

Uterine Artery Embolization for fibroids

(Uterine-sparing treatment)

Uterine fibroids (myomas, leiomyomas, or fibromyomas) are the most frequent tumors of the female genital tract: 20 to 40% of women of childbearing age have a fibroid. Fibroids range in size from very tiny to the size of an orange or larger. In some cases, they can cause the uterus to grow to the size of a five-month pregnancy or more. Fibroid may be located in various parts of the uterus. There are three primary types of uterine fibroids, Subserosal, Intramural and Submucosal fibroids.

Depending on location, size and number of fibroids, they may cause:

1. Heavy, prolonged menstrual periods and unusual bleeding, sometime with clots. This might lead to anemia.
2. Lower abdomen, back or leg pain
3. Lower abdomen pressure or heaviness
4. Bladder pressure leading to a constant urge to urinate
5. Pressure on bowel, leading to constipation and bloating
6. Abnormally enlarged abdomen

 Fibroid can be located in various parts of the uterus.
Fibroids are usually diagnosed during a gynecologic examination. The presence of fibroids is most often confirmed by a lower abdomen ultrasound. Fibroids can also be confirmed using MRI (magnetic resonance imaging). These imaging techniques serve as a baseline examination for follow-up after uterine fibroid embolization (UFE).

New Treatment for uterine fibroids: -

Minimally Invasive Therapy (Uterine artery or fibroid embolization / Uterine-sparing treatment).

It is a minimally invasive interventional radiological procedure, which means it requires only a tiny nick in the skin. It is performed under sedation and local anesthesia – feeling no pain and usually requires a hospital stay of one night. Many women resume light activities in a few days and the majority of women are able to return to normal activities within one week.

Ideal Patient for uterine artery embolization.

1. They have single / multiple fibroids
2. The fibroids are symptomatic
3. There is no cancer

UFE treats all uterine fibroids at the same time and is, therefore, an extremely effective.
The interventional Radiologist makes a small nick in the skin (less the ¼ of an inch) at groin, inserts a catheter, identifies uterine artery by using angiography with contrast media injection and then inject embolization particles (polyvinyl alcohol) that block the tiny vessels supplying all the fibroids. This blockade of blood supply to fibroids causes infarction(loss of blood supply to the fibroids) and subsequent degeneration of the fibroids and it starts reducing in size reaching half the size in few weeks. Symptoms due to the fibroids (like bleeding and pain) resolve in 85% to 95% of patients.

 A. Embolization preparation. A tiny angiographic catheter is inserted through a nick in the skin in to an artery and advanced into uterus.

 B. Injection. Tiny polyvinyl alcohol particles of 500 um in diameter are wedge in the small arteries, blocking the blood flow to the fibroids.

While embolization to treat uterine fibroids has been performed since 1995, embolization of the uterus is not new. It has been used successfully by interventional radiologist for over 20 years to treat heavy bleeding after childbirth. The procedure is now available at hospitals.

Advantages of Uterine artery embolization

1. It is performed under Local anesthesia. Not General anesthesia.
2. Requires only a tiny nick in the skin (No surgical incision of abdomen).
3. Recovery is shorter than from hysterectomy or open myomectomy.
4. Virtually no adhesion formation has been found. But in surgery adhesions are common.
5. All fibroids are treated at once, which is not the case with myomectomy.
6. There has been no observed recurrent growth of treated fibroids in the past 9 years.
7. Uterine fibroid embolization involves virtually no blood loss or risk of blood transfusion.
8. If the presenting complaint was excess vaginal bleeding, 87-90% of cases experiences resolution within 24 hours.
9. Emotionally, financially and physically – embolization can have an overall advantage over other procedures for the patient as the uterus is not removed.

 A. Before embolization angiography shows multiple abnormal arteries feeding to fibroids.

B. After embolization of fibroids abnormal vessels are occluded while the normal (uterine) myometrial branches are still patent.
This technique is considered a safe alternative to hysterectomy and myomectomy.


For more in-depth information on fibroids embolization contact Dr.Pradeep Muley M.D. Body & Neuro Interventional Radiologist. Working at Fortis Hospital, Vasant Kunj, New Delhi, Batra hospital & Research Centre, New Delhi & Artemis Health Institute (AHI), at Gurgaon (call at mobile 91-098104 92778)