![]() ![]() Because of these unique properties, incomplete embolization may occur if the interventionalist is not familiar with proper nPVA embolization technique. Over minutes, these clumps break down and penetrate deeper into the smaller vessels, causing more distal embolization while allowing recanalization of the parent artery. Given these characteristics, the particles tend to clump. 7,19 True to its name, nPVA is irregular in shape and size. The first studies performed for UFE used nonspherical polyvinyl alcohol (nPVA). This article reviews the literature on the currently available embolic agents to help guide the interventionalist. A variety of embolics are available for UFE, and many are FDA approved for the treatment of uterine fibroids ( Table 1). The size of embolic particles used should be targeted to the perifibroid plexus, not the smaller normal arterioles of the myometrium smaller particles should be avoided because they lead to myometrial infarction. 16-18 The vessel diameter in the perifibroid plexus usually ranges from 500 to 1,000 µm. The actual fibroids are fed via a dense vascular network referred to as the perifibroid plexus, which is larger in diameter and has less tapering than the vessels supplying the surrounding myometrium. ![]() ![]() 15 CURRENTLY APPLICABLE EMBOLIC MATERIALSįibroids are hypervascular tumors that increase blood supply to the fibroids as well as the normal myometrium, leading to hypertrophy of the uterine arteries ( Figure 1). 8-14 This repeatedly showed equivalent patient satisfaction and quality-of-life (QOL) outcomes, which led the American College of Obstetricians and Gynecologists to recognize UFE as a safe and effective alternative to hysterectomy. 7 Since then, it has been extensively studied with multiple randomized controlled trials comparing UFE to surgery. 5,6 Uterine fibroid embolization (UFE) was first described in 1995 by Ravina et al. Fibroids are responsible for approximately 29% of gynecologic hospitalizations and 40% to 60% of hysterectomies. 4 Women most commonly present with heavy periods, painful menstrual cycles, or bulk symptoms. 1-3 Fibroids are found in more than 70% of women by the onset of menopause however, approximately 25% of women have symptoms severe enough to seek treatment. Uterine fibroids (leiomyoma) are the most common pelvic tumor in women. ![]()
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