Embolization is a technique where a catheter is passed through the artery supplying a region and a material is injected which blocks blood flow. The catheter is placed from the artery in the groin and advanced to the area of interest. Embolization therapy has been used for many years for the control of bleeding caused by trauma and the treatment of other tumors within the body. This technique has been used for close to 40 years.
The procedure was first used in Europe to decrease blood loss that can occur during myomectomy. Many women found that after the embolization procedure their symptoms improved, the remaining fibroids shrunk in size, and surgery was no longer necessary. This prompted physicians to use this as a standalone therapy.
The procedure takes about an hour to complete. The total time within the room can be as much as 2 hours depending upon your anatomy and the time required for sedation.
Will I feel the catheter going through my arteries? You may have sensation in the groin where the artery is accessed. To treat this, a combination of sedation and local anesthetic is used. There is no sensation within the arteries as the catheter travels through them. A sense of warmth may be felt when contrast is injected into the artery. Otherwise, there should be no awareness of the catheter or the embolization itself.
Women typically complain of severe menstrual-like cramps following the procedure. This is the reason we have chosen to keep women in the hospital the first night. The day after the procedure, the pain is usually improved and much more responsive to oral medications. Pain medication is usually needed for the first 3 to 7 days following the procedure and may be stopped sooner if the patient feels she no longer needs them.
Is it necessary to stay in the hospital after the procedure? We have been performing UFE since 1999 and have found that patients are better taken care of if they stay overnight in the hospital. The main concerns following the procedure are pain and nausea. These are best handled with intravenous medication. This results in most women tolerating conversion to oral medications for adequate pain control.
UFE has been studied broadly by radiologists and gynecologists over the past 15 years. It resolves pain and bleeding 80 to 90% of the time. Fibroids will typically shrink 20 to 50% in the first 3 months and between 40 and 70% within a year.
Multiple studies have shown UFE to be safer than the surgical alternatives. The risk of complication related to surgery is between 17% and 23% compared with 5% for UFE. The recurrence risk of fibroids with myomectomy is 23-51% over 5 years compared with 8% in women treated with UFE.