Uterine fibroid embolization (2026)

Description

Authors: V. Bérczi and K. Pyra

Reviewers: M. Mauda-Havakuk, M. Szmygin, and R. Uberoi

This course corresponds to chapter 2.2.1.1.9 Arterial problems in obstetrics and gynaecology in the European Curriculum and Syllabus for Interventional Radiology.

Abstract

A uterine fibroid (leiomyoma) is a specific type of benign tumour that occurs in the muscle cells of the uterus, a condition affecting up to 70% of premenopausal women. However, only up to 25% of premenopausal women actually develop symptoms due to fibroids, such as painful or heavy periods, frequent urination, or pelvic pain. The main factors that determine whether a fibroid causes symptoms are growth and location. The exact cause of uterine fibroids is unclear, and treatment is typically not needed if there are no symptoms. After menopause, they usually decrease in size. Treatment should be considered for patients who report symptoms associated with the presence of fibroids, starting with the least invasive methods. Pharmacological treatment, myomectomy, HIFU, and embolization are some examples. Each method has its own indications. Fibroid size, number, and location are three potential predictors of successful UFE. Good cooperation with the gynaecologist is ideal to enable informed decisions and an appropriate choice of therapy for the patient.

The UFE is not technically very complicated for experienced interventional radiologists but requires gentleness and patience. The procedure usually proceeds similarly, differing only in vascular access (femoral artery, brachial, radial) and the equipment used. Transradial access (in women up to 178 cm in height) was recently shown to have similar technical and clinical outcomes, with low access-site complications associated with both approaches. The aim is to place the catheter selectively into the uterine artery and then safely embolize 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 that leads to substantial improvements in quality of life and symptom control, with exceptionally low rates of serious complications in most patients. The five-year QoL outcomes are equal in both groups (hysterectomy vs UFE) with no difference in major complications. Embolization is an important alternative due to its high efficiency and low invasiveness. Uterine artery embolization is safe and effective in adenomyosis, also.

Learning objectives

• Gain an understanding of the vascular anatomy relevant to uterine fibroid embolization (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 embolization in the management of uterine fibroids
• Understand the indications and contraindications for UFE
• Recognise the limitations of current embolization techniques
• Understand the principles of UFE, as well as likely outcomes and potential complications
• Understand the differences between post-embolization syndrome and unusual but normal symptoms after embolization, as well as potential complications, and become familiar with the published literature relating to these different outcome points.

Further information

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 Interventional Radiology and corresponds to chapter 2.2.1.1.9 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 and a half hours and is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to award 2.5 European CME credits (ECMEC). Please note that this course will be taken offline on July 02, 2031.

The acquired CME Certificate will be available in the myCIRSE area under CIRSE Academy.

The enrolment period of this course is linked to the validity of the All-Access Pass.

Release date: July 2026