Embolization is a technique that was invented in the 1960's to stop bleeding. A tiny catheter (a thin, hollow tube) is inserted into a bleeding vessel, and material is injected through the catheter. The material is carried by flowing blood until it lodges at the bleeding site. As the material builds up, it acts like the branches of a beaver's dam. When enough material is in place, the flow of blood stops.
|In this drawing, the catheter is injecting tiny plastic particles into the artery, which block blood flow to the fibroid. (drawing courtesy of The Oregonian)
|This drawing shows the small catheter that has been introduced at the groin and passed to the uterine artery. (drawing courtesy of The Oregonian)
Since the 1960's, embolization has been used to treat
tens of thousands of people with bleeding from ulcers,
tumors, and trauma. It has also been used to stop the bleeding
that can sometimes occur after
childbirth. The materials most often used–called polyvinyl
alcohol (a powder, not a liquid), acryilic spheres, gelfoam,
and tiny steel coils–are approved by the U.S. Food and Drug Administration (FDA) for
this purpose. Embolization is in common use around the
world, and is known to be safe and effective when properly
History of embolization for fibroids (UFE)
In the early 1990's, a French gynecologist named Dr. Ravina asked his local Interventional Radiologist to embolize the fibroids of several of his patients before they had hysterectomies. He did this because he knew the embolization would reduce bleeding in the operating room. To his pleasant surprise, he found that the fibroids began shrinking, and many of the patients no longer needed a hysterectomy. He published his findings in the English Medical Journal "Lancet" in 1996, and numerous others have since duplicated his results.
Results of UFE
In published medical studies. fibroids treated with uterine fibroid embolization (UFE) have been reduced in size by up to 65%. In a study of 250 women, one researcher found fibroids to be reduced by at least half their original size in 87% of his patients. Symptoms are relieved or significantly improved in up to 90% of women, and 75-100% of women surveyed in various studies said they were very happy with their results.
Many women are able to leave the hospital on the day of the procedure, and the rest usually go home the next day. Recovery periods are short: most women are back to work in a week, and feel "back to normal" within two weeks. Fibroids symptoms go away over a period of weeks to months, with the greatest improvement occurring over the first 8 weeks.
Who does the procedure?
UFE is performed by medical doctors called Interventional Radiologists (IR's). IR's can be thought of as non-invasive surgeons. Working through small entry sites in the skin, they use tiny balloons to open blocked vessels, inject particles or metal coils into vessels to stop blood flow, place chemotherapy materials directly into tumors, and many other similar procedures.
Interventional radiologists go through a long period of training. After college and four years of medical school, they complete a four-to-five-year training program in ultrasound, CT scanning, MRI, X-ray examinations, and other techniques that produce pictures of medical diseases. After that, IR's complete another one-to-two years of training, learning the "catheter surgery" techniques. After this training, IR's go through written and oral examinations by a panel of experts, and are then certified by the American Board of Radiology.
You can find an IR in your area by visiting the home
page of the Society of Interventional Radiology (SIR).
A fully qualified Interventional Radiologist will either have (or be eligible for) Board Certification and a special Certificate of Added Qualification (CAQ).
A list of medical references and other information is available by request (telephone 503 494-7660; FAX 503494-7664). Alternatively, this information can be downloaded as a .PDF file by clicking here.