Uterine Artery Embolization of Uterine Fibroids

T he uterus is the most common site to develop smooth muscle tumors. Uterine fibroids (leiomyomas) contain benign smooth muscle and fibrous tissues. Twenty percent to 40% of reproductive age women develop uterine fibroids, with a higher incidence in African Americans. Although the decline in hormonal stimulation causes most fibroids to regress at menopause, 20% become symptomatic before then. Uterine artery embolization (UAE, alternatively uterine fibroid embolization or UFE) was accidentally discovered and reported in 1994 by the French physician, Dr. J.H. Ravina.1 Ravina pretreated patients scheduled for myomectomy with pelvic embolization for the purpose of reducing operative blood loss. Subsequently, many patients canceled their myomectomy due to symptomatic improvements. Over the following years, it has been found that most uterine fibroids are amenable to UAE, and current estimates are that 13,000 to 14,000 UAEs are performed annually in the US alone.2 The FDA has approved specific embolic materials for endovascular treatment of symptomatic uterine fibroids.3