Embolotherapy

Uterine fibroid embolization

Uterine fibroids are the most common tumor of the female reproductive tract in premenopausal women. It is a benign tumor but can cause heavy menstrual bleeding, pelvic pain and pressure, and urinary frequency and urgency. While hormone therapy and endometrial ablation are treatment options, fibroids are the most common reason for hysterectomy in the United States. Imaging via ultrasound or MRI is useful to evaluate the size, location and number of fibroids and to help decide what type of treatment is appropriate.

For patients who desire to preserve their uteri, embolization, or blockage of blood flow to the fibroid tumors via the uterine or ovarian arteries, leads to gradual shrinkage in size of the fibroid over several months to years.

Symptoms have been shown to improve in 85-95 percent of patients by 3 months post-procedure. Postembolization syndrome may occur in 1-5% during the recovery period and involves pelvic pain, fever and fatigue. Other rare complications include infection, pulmonary embolism, fibroid expulsion through the cervix and transient or permanent amenorrhea.

There may be some decreased ability to conceive or increased risk of miscarriage after embolization, but these effects on reproduction are still under study and should be discussed with your gynecologist. Recurrent symptoms may occur in up to one quarter of patients and require repeat treatment or hysterectomy.

Vascular malformations

Signs of vascular anomalies may first be noticed in childhood and include a vascular birthmark, varicose veins, asymmetric enlargement of a limb or a distinct mass. Diagnosis can often be made using noninvasive vascular studies, radionuclide shunt exam and MRI or CT. Venous malformations are the most common congenital vascular anomaly. Treatment options may include laser therapy, sclerotherapy, embolization and resection.

Hepatic arterial embolization

For patients with primary or metastatic tumors of the liver, catheter-directed embolization therapies are able to deliver chemotherapeutic or radioactive agents directly to the tumor, while also blocking the primary blood supply of the tumor. We work closely with the two surgical oncologists in our group and the radiation and oncology services at Mills-Peninsula to determine what kind of therapy is the most appropriate.