Uterine fibroid embolisation (CME) – online course
Authors: V. Bérczi and K. Pyra
Reviewers: M. Deutschmann, M. Hoffmann, T. Jahnke, L. Kamper and C. Nice
This course corresponds to chapter 126.96.36.199.9 Arterial Problems in Obstetrics and Gynaecology in the European Curriculum and Syllabus for IR.
A uterine fibroid (leiomyoma) is a specific type of benign tumour that occurs in the muscle cells of the uterus, a condition affecting approximately 20-40% of premenopausal women. However, only 5-10% of premenopausal women actually develop symptoms due to fibroids, such as painful or heavy periods, frequent urination or pelvic pain. Growth and location are the main factors that determine if a fibroid leads to symptoms. The exact cause of uterine fibroids is unclear. Treatment is typically not needed if there are no symptoms. After menopause, they usually decrease in size. In patients who report symptoms associated with the presence of fibroids, their treatment should be considered, starting from the least invasive. Pharmacological treatment, myomectomy, HIFU or embolisation are some of them. Each method has its own indications. Fibroid size, number and location are three potential predictors of successful UFE. Good cooperation with the gynaecologist which helps to properly qualify and prepare patients for the procedure.
The UFE technically is not very complicated for experienced interventional radiologists, but requires gentleness and patience. The procedure usually proceeds similarly, differing only with vascular access (femoral artery, brachial, radial) and the equipment used. The aim is to place the catheter selectively into the uterine artery and then safely embolise it using particles. Certain steps should be kept in mind, because, if ignored or performed carelessly, they will have corresponding consequences.
UFE is a safe treatment option leading to substantial improvement in quality of life and symptom control in the majority of patients, with exceptionally low rates of serious complications. The five-year QoL outcomes are equal in both groups (hysterectomy vs UFE) with no difference in major complications. Embolisation is an important alternative due to its high efficiency and low invasiveness.
- Gain an understanding of the vascular anatomy relevant to uterine fibroid embolisation (UFE)
- Understand the pathophysiology of uterine fibroids and become familiar with their clinical presentation
- Understand the role of radiological imaging modalities prior to endovascular treatment
- Understand the role of medical, surgical and endovascular treatment options for UFE
- Understand the role of embolisation in the management of uterine fibroids
- Understand the indications and contraindications for UFE
- Recognise the limitations of current embolisation techniques
- Understand the principles of UFE, as well as likely outcomes and potential complications
- Understand the differences between post-embolisation syndrome, unusual, but correct symptoms after embolisation and potential complications, and become familiar with the published literature relating to these different outcome points.
This course covers a basic level of IR knowledge and is designed for trainees, students or young consultants aiming to acquire essential knowledge or prepare for the EBIR exam. Thereby, it is tailored to the European Curriculum and Syllabus for IR and corresponds to chapter 188.8.131.52.9 Arterial Problems in Obstetrics and Gynaecology.
The format of the course is interactive and easy to use, including texts, graphics, videos and a quiz to support your learning. The course duration is around two hours and is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to award 2 European CME credits (ECMEC). The CME accreditation for this course will expire on September 5, 2021. A non-CME accredited version of the course will remain available until the new CME accredited course is published.
Upon purchase, access to complete and revisit the course is granted for an enrolment period of 90 days.
The CME certificate will be available in the myCIRSE area past the enrolment period if the course is completed before September 5, 2021.
Release date: September 2019