A small nick is made in the skin, usually in the right groin (less than 1/8 of an inch), at the crease at the top of the leg. A tiny tube (catheter) is inserted into the artery at this level. Local anesthesia will be given so that this needle puncture is not painful. Thus, the only thing the patient should feel during the examination is the initial numbing and the remainder of the procedure should be painless.
Using x-ray guidance the radiologist will guide the catheter into the appropriate place within the uterine artery and perform the embolization.
The Interventional Radiologist will then slowly inject tiny particles (polyvinyl alcohol, gel foam, or Embosphere®) into the artery. These particles flow to the fibroid first and wedge in these vessels and remain there. After a few minutes the arteries are slowly blocked. The same procedure is repeated on the other side so that the blood flow is blocked from the right and left uterine arteries. Once the embolization is complete, an arterogram is repeated to confirm the results. All of this is done through the same single, tiny nick in the groin. This nick is considerably smaller than any other surgical opening even with robotic or laparoscopic techniques.
August 2008 Practice Recommendations From American College of Obstetricians and Gynecologists Say Uterine Fibroid Embolization Is “Safe and Effective,” Based on Good, Consistent Level A Scientific Evidence:
“Based on long- and short-term outcomes, uterine fibroid embolization, a minimally Invasive interventional radiology treatment for uterine fibroids, is a safe and effective option for women to consider. Women can and should be confident about their decision to consider UFE as a treatment option. Level A treatment choices are considered proven treatments that should be offered to patients for their conditions when discussing treatment options. ACOG’s Practice Bulletin is used to aid doctors in making decisions about appropriate patient care. Most women with symptomatic fibroids are candidates for UFE and should obtain a consult with an interventional radiologist to determine whether UFE is a treatment option for them.”