WHAT / WHY
Uterine artery embolization is a new approach to treating fibroid tumors. This procedure is performed by an interventional radiologist trained in the use of X-rays to guide catheters within the arteries. The procedure involves gaining access to the femoral artery through a skin nick at the top of the leg. A thin tube or catheter is guided to the artery that brings blood to the uterus, and very small particles are injected through the catheter to block the blood supply to the fibroid tumor. This causes the tumors to shrink. The results obtained will vary from patient to patient. If you have any questions regarding the following information, please call the Interventional Radiology Section at (734) 655-2507.
INSTRUCTIONS
· If you take a medication called Coumadin, stop taking it 5 DAYS before your test. If you are taking Plavix, Aspirin or an Aspirin product, you may continue to take them.
· If you are an insulin dependent diabetic, take 1/2 your insulin dose the morning of your test, unless otherwise directed by your doctor.
· If you are on oral medications for diabetes, do NOT take your dose on the morning of your test. If you take glucophage or glucovance, do NOT resume taking it until directed to do so by your physician.
· You may take your other prescribed medication the morning of the test.
· Take nothing except your medications after 12:00 A.M. (midnight) the day of your test.
· Please leave your valuables at home. Do not wear any jewelry to the hospital. The hospital is not responsible for lost personal articles or valuables.
· You will be observed in the Phase III recovery until a bed is ready for you for your overnight stay.
· You must arrange for someone to drive you home when discharged from the hospital the next morning. It is advisable to arrange for an adult to help you at home for the first 24 hours.
PRE-PROCEDURE TESTING
· A doctor (interventional radiologist) in the Radiology Department will discuss your test and possible complications in detail. You will have an opportunity to ask questions and discuss any concerns.
· We will draw your blood to check your kidney function and your bloods ability to clot.
· You will sign a consent form giving the interventional radiologist permission to do the fibroid embolization.
Day of your Test
· The day of your test, go directly to the Out patient Services area, which is on the 2nd floor. Come in the South Entrance of the hospital. Follow the signs to Outpatient Services. They will direct you from there where to go.
· An intravenous solution (I.V.) will be started. If you need medication during the test, it can be given through this I.V.
· A Foley Catheter will be placed in your bladder to drain your urine for the procedure and will be left in place until the next day.
· The nursing staff will obtain your vital signs and perform a nursing assessment. Please bring a list of the medications that you are taking.
Special Procedures Department
· In the X-Ray room you will see a lot of equipment. Radiology technologists will help the Radiologist. The following will occur
· You will be helped onto a special X-Ray table.
· An EKG monitor and blood pressure cuff will be attached to you. This will record the activity of your heart during the test and monitor your blood pressure automatically at predetermined intervals. The nurse present will monitor this.
· The catheter insertion area will be shaved. This will be the groin usually on the right side near your hip.
· The catheter insertion area will be cleansed with antiseptic solution, which feels cold.
· Sterile towels will be placed around the catheter insertion area.
· The radiologist will inject a local anesthetic to numb the area where the catheter will be inserted. The nurse will administer sedation and pain control as needed under the Doctor’s supervision through the IV that was started in Pre-op.
· A catheter will be inserted into a blood vessel and advanced to the blood vessel(s) to be studied and eventually embolized.
· Colorless x-ray dye will be injected through the catheter and into the blood vessel(s). You may feel a warm sensation as the dye is injected. It will last only a few seconds. The dye will leave your body when you urinate. The color of your urine will not change. The particles to obstruct the uterine arteries are injected through the same catheter after confirming placement.
· You must lie still to avoid blurring the film. You will be asked to hold your breath at certain stages of the test.
· When the radiologist has completed the embolization, the catheter is removed.
· The radiologist will hold firm pressure on the insertion site puncture site until the bleeding has stopped.
AFTER CARE
· You will be transported to Phase III Recovery area after your procedure is over. A PCA pump will be started and you will be instructed on the use of it to control your pain. You will be transported up to an available bed in the hospital overnight.
· You must keep the leg that was used for the test straight and keep your head down for up to 6 hours. This is will be determined by the Doctor and the length of the procedure. You will stay in bed with the head of the bed up 20 degrees.
· Your nurse will check the puncture site for bleeding or swelling. This will be done often for the first two hours.
· You may have a bruise, or you may feel some discomfort at the puncture site, which is normal. Cramping is also normal after this procedure along with some uterine discharge. The Doctor will also administer medications for nausea & vomiting and antibiotic therapy.
· The radiologist will report the outcomes to your OB/GYN, which will then follow-up with you.
· You will receive written discharge instructions before you are discharged.
Exams, as well as, procedure complexity vary from patient to patient. This is to serve as a general guideline for this procedure. This publication is designed to provide information. It is not intended to substitute for the professional advice of your physician. If medical advice is required, call your physician.
