Women’s Health

Women have unique health issues.  Some of these unique health issues can include pregnancy, menopause, and conditions of the female organs.  At the Vascular Institute of Virginia we specialize in treating some of the unique health conditions that can affect the female population.

Uterine Fibroid Embolization

Uterine fibroids are very common non-cancerous (benign) growths that develop in the muscular wall of the uterus. 

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They can range in size from very tiny (a quarter of an inch) to larger than a cantaloupe. Occasionally, they can cause the uterus to grow to the size of a five-month pregnancy. In most cases, there is more than one fibroid in the uterus.

While fibroids do not always cause symptoms, their size and location can lead to problems for some women, including pain and heavy bleeding.  Subserosal fibroids develop under the outside covering of the uterus and expand outward through the wall.  They can cause pelvic pain, back pain and generalized pressure.  Intramural fibroids develop within the lining of the uterus and expand inward.  These are the most common type and can result in heavier menstrual bleeding and pelvic pain, or back pain.  Submucosal fibroids develop just under the lining of the uterus.  Even a very small submucosal fibroid can cause heavy bleeding (gushing) and very prolonged periods.

Magnetic Resonance Imaging (MRI) is the standard imaging tool used by interventional radiologists to diagnose uterine fibroids.

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Uterine fibroid embolization (UFE), also known as uterine artery embolization, is performed by an interventional radiologist, a physician who is trained to perform this and other types of embolization and minimally invasive procedures.  It is performed while the patient is conscious, but sedated and feeling no pain. It does not require general anesthesia.The interventional radiologist makes a tiny nick in the skin in the groin and inserts a catheter into the femoral artery. Using real-time imaging, the physician guides the catheter through the artery and then releases tiny particles, the size of grains of sand, into the uterine arteries that supply blood to the fibroid tumor. This blocks the blood flow to the fibroid tumor and causes it to shrink and die.

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Fallopian Tube Recanalization

A common cause of female infertility is a blockage of the fallopian tubes, usually as the result of debris that has built up.  Occasionally, scarring from surgery or serious infection can lead to a blockage as well.  Fallopian tube recanalization (FTR) is a non-surgical procedure an interventional radiologist uses to treat these blockages.  

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Recanalization is the medical term for “reopening”.  During the procedure, which does not require any needles or incisions, the physician will place a speculum into the vagina and pass a small plastic tube (catheter) through the cervix into the uterus.  Through this liquid contrast, sometimes referred to as x-ray dye, is injected in order to visualize the uterine cavity and the fallopian tubes.  This will help determine if there is a blockage and whether is on one or both sides.  To clear the blockage, a smaller catheter and/or wire will be threaded through the first catheter and then into the fallopian tube.

Ovarian Vein Embolization for Pelvic Congestion Syndrome

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Chronic pelvic pain is very common in women and can potentially lead to significant disability. Approximately one out of every three women will suffer from pelvic pain at some point during their lifetime. It is described as "non-cyclic" pain lasting greater than six months in duration.

Ovarian vein embolization is a minimally invasive treatment for pelvic congestion syndrome that is used to close off faulty veins so they can no longer enlarge with blood, thus relieving the pain.

Pelvic congestion syndrome, also known as ovarian vein reflux, is a painful condition resulting from the presence of varicose veins in the pelvis. The condition is caused by valves in the veins that help return blood to the heart against gravity becoming weakened and not closing properly, allowing blood to flow backwards and pool in the vein causing pressure and bulging veins. Diagnosis of the condition is done through one of several methods: pelvic venography, magnetic resonance imaging and pelvic and transvaginal ultrasound.

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During this procedure, an interventional radiologist inserts a catheter into the jugular vein down into the faulty vein(s). Catheterization requires only a small nick in the skin for insertion and x-ray image guidance of the catheter to its target area. The catheter delivers Dacron filaments-bearing coils that clot the blood and seal the faulty vein. The use of the recently developed Sotradecol foam agent allows the radiologist to block even the smallest veins not previously accessible.