Uterine Artery Embolization (UAE) is a new minimally-invasive treatment for women with symptomatic uterine fibroids. This procedure is proving to be a valuable alternative to hysterectomy, myomectomy and other surgical treatment options for women. UAE is performed by a specialized interventional physician under local anesthesia. A small catheter is inserted into a blood vessel in your groin and threaded into the arteries to your uterus. Small particles are injected through the catheter to decrease blood flow to the fibroids, which usually causes them to shrink. In most patients, bleeding and pressure-related symptoms are significantly reduced.

History of UAE

Used primarily for acute hemorrhage, embolization is an established and highly-effective safe therapy. In the early 1990s, a French gynecologist explored uterine artery embolization therapy as an option to minimize intraoperative bleeding during fibroid surgeries. UAE provides reliable relief of both menorrhagia and bulk-related symptoms of fibroids. With a lower morbidity rate and faster recovery, UAE is proving to be a valuable alternative for women.

The Procedure UAE is typically performed by an interventional radiologist under general anesthesia. An incision is made through the groin where a tiny catheter is inserted into the femoral artery of the leg. Using fluoroscopy, or xray imaging, the radiologist maneuvers the catheter through the femoral artery to the uterus.

To provide a map of the blood supply to the uterus and fibroids, a series of pictures are taken while radiographic dye is injected. Embolization particles are then injected into the blood vessel. The particles flow to where the fibroids are first and cannot travel to other parts of the body. The embolization particles are tiny polyvinyl alcohol or gelatin sponge particles the size of a grain of sand. The embolization continues until blood flow to the vessel is nearly complete. The embolization particles have been safely used in humans for several years. The embolization procedure is then repeated on the other side so both the left and right uterine arteries are blocked. After UAE, another arteriogram is taken to confirm that blood flow to the fibroids is blocked from both sides. As a result of UAE, the fibroids will begin to shrink and eventually disappear.

BEFORE UAE Arteriogram of pelvic arteries shows enlarged uterine artery supplying fibroids.

AFTER UAE Arteriogram after UAE shows plugged uterine artery.

Expected Results

After UAE, most women experience a significant decrease in the amount of menstrual bleeding. Over several weeks, pelvic pain and abdominal pressure will decrease as the fibroid continues to shrink. Typically, an Ultrasound, CT or MRI will be performed about four to six weeks after the procedure to monitor the effectiveness.

The size of the fibroid is reduced by 50 percent after three months with the uterus size reduced by nearly 40 percent. No long-term outcomes are available at this time as it is not yet known if the fibroids can re-grow. Currently, no known fibroid recurrences have been documented in women who have been in follow-up care for up to six years.