title: Successful fibroid embolization of pelvic and inferior mesenteric artery collaterals after previous uterine artery embolization.
abstract: A 47-year-old woman with a history of myomectomies and uterine artery embolization 15 years previously presented with increasing menorrhagia and dysmenorrhea. Magnetic resonance imaging (MRI) demonstrated multiple enhancing fibroids, extensive uterine supply from what appeared to be patent uterine arteries, and significant supply from what appeared to be the left ovarian artery. Aortography demonstrated no ovarian supply, but extensive collateral supply from distal branches of the inferior mesenteric artery (IMA), with further collateral supply from the anterior division of both internal iliac arteries. There was no filling of the uterine arteries distal to the coils. Embolization was performed with technical and clinical success. This case highlights the potential for recruitment of collateral vessels following coil embolization and is the first reported case of successful fibroid embolization from distal IMA branches.
authors.affiliation: Department of Radiology, The John Radcliffe Hospital, Oxford, UK. shaheen7noorani@gmail.com
authors.forename: Shaheen
authors.initials: S
authors.lastname: Dixon
authors.forename: Charles Ross
authors.initials: CR
authors.lastname: Tapping
authors.forename: Phei Shan
authors.initials: PS
authors.lastname: Chuah
authors.forename: Mark
authors.initials: M
authors.lastname: Bratby
authors.forename: Raman
authors.initials: R
authors.lastname: Uberoi
authors.forename: Susan
authors.initials: S
authors.lastname: Anthony
mesh_terms: D015901:Angiography, Digital Subtraction / Q000379:methods; D003097:Collateral Circulation; D003287:Contrast Media; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007889:Leiomyoma / Q000098:blood supply / Q000628:therapy*; D008279:Magnetic Resonance Imaging / Q000379:methods; D017537:Mesenteric Artery, Inferior / Q000000981:diagnostic imaging / Q000473:pathology; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D008863:Microspheres; D008875:Middle Aged; D010388:Pelvis / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D016896:Treatment Outcome; D055357:Uterine Artery Embolization; D014599:Uterus / Q000098:blood supply* / Q000473:pathology
chemical_list: D003287:Contrast Media