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European Radiology

, Volume 15, Issue 6, pp 1168–1172 | Cite as

Uterine artery embolisation for uterine fibroids using a 4F Rosch inferior mesenteric catheter

  • Simon S. M. Ho
  • Nigel C. Cowan
Urogenital

Abstract

Purpose: To evaluate in a prospective study the use of a 4F Rosch inferior mesenteric (RIM) catheter for uterine artery embolisation (UAE). Materials and methods: UAE was performed in 72 women over a 37-month period. A 4F RIM braided J-curve 65-cm catheter was used in combination with an angled hydrophilic 150 cm, 0.035” flexible tip guide-wire to catheterise the horizontal portion of both uterine arteries (UA) from a right common femoral artery (CFA) approach. Technical success was defined as successful catheterisation and embolisation of both uterine arteries. Fluorosocpic and procedure times were recorded. Results: Mean subject age=43.7 years (range=25–57 years). Technical success was 98.6% (n=71/72). A single approach via the right CFA was used in 88.9% (n=64/72) and a bilateral CFA approach in 11.1% (n=8/72). Bilateral uterine artery catheterisation using a single 4F RIM catheter via the right CFA approach was successful in 79.2% (n=57/72). Microcatheters were used in 2.8% of patients (n=2/72). Mean fluoroscopic time=13.6±5.3 min (mean±SD). Mean procedure time=44.2±16.5 min. Conclusion: High technical success rate for UAE is possible using a single 4F RIM catheter via a unilateral right CFA approach, which obviates the need for Waltman loop formation, reversed curve catheters and complex suture-catheter arrangements.

Keywords

Uterine artery embolisation Rosch inferior mesenteric catheter (RIM) Leiomyoma Fibroids 

References

  1. 1.
    Goodwin SC, Vedantham S, McLucas B, Forno AE, Perella R (1997) Preliminary experience with uterine artery embolization for uterine fibroids. J Vasc Interv Radiol 8:517–526PubMedGoogle Scholar
  2. 2.
    Worthington-Kirsch RL, Popky GL, Hutchins FL Jr (1998) Uterine artery embolization for the management of leiomyomas: quality-of-life assessment and clinical response. Radiology 208:625–629Google Scholar
  3. 3.
    Pelage JP, Soyer P, Le Dref O, Dahan H, Coumbaras J, Kardache M, Rymer R (1999) Uterine arteries: bilateral catheterization with a single femoral approach and a single 5-F catheter—technical note. Radiology 210:573–575Google Scholar
  4. 4.
    Siskin GP, Stainken BF, Dowling K, Meo P, Ahn J, Dolen EG (2000) Outpatients uterine artery embolization for symptomatic uterine fibroids: experience in 49 patients. J Vasc Interv Radiol 11:305–311PubMedGoogle Scholar
  5. 5.
    Vetter S, Schultz FW, Strecker EP, Zoetelief J (2004) Patient radiation exposure in uterine artery embolization of leiomyomata: calculation of organ doses and effective dose. Eur Radiol 14:842–848CrossRefPubMedGoogle Scholar
  6. 6.
    Pinto I, Chimeno P, Romo A, Paúl L, Haya J, de la Cal MA, Bajo J (2003) Uterine fibroids: uterine artery embolization versus abdominal hysterectomy for treatment—a prospective, randomized, and controlled clinical trial. Radiology 226:425–431PubMedGoogle Scholar
  7. 7.
    Nikolic B, Spies JB, Lundsten MJ, Abbara S (2000) Patient radiation dose associated with uterine artery embolization. Radiology 214:121–125PubMedGoogle Scholar
  8. 8.
    Nikolic B, Spies JB, Campbell L, Walsh SM, Abbara S, Lundsten MJ (2001) Uterine artery embolization: reduced radiation with refined technique. J Vasc Interv Radiol 12:39–44PubMedGoogle Scholar
  9. 9.
    Pron G, Bennett J, Common A, Sniderman K, Asch M, Bell S, Kozak R, Vanderburgh L, Garvin G, Simons M, Tran C, Kachura J (2003) Technical results and effects of operator experience on uterine artery embolization for fibroids: the Ontario uterine fibroid embolization trial. J Vasc Interv Radiol 14:545–554PubMedGoogle Scholar
  10. 10.
    Shlansky-Goldberg R, Cope C (2001) A new twist on the Waltman loop for uterine artery embolization for fibroids. J Vasc Interv Radiol 12:997–1000PubMedGoogle Scholar
  11. 11.
    Andrews RT, Brown PH (2000) Uterine arterial embolization factors influencing patient radiation exposure. Radiology 217:713–722PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  1. 1.Department of Diagnostic Radiology and Organ Imaging, The Prince of Wales HospitalThe Chinese University of Hong KongHong KongChina
  2. 2.Department of RadiologyThe Churchill HospitalOxfordUK

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