In Reply to: Case 1199_01 -- Embolization of Dominant Ovarian Arterial Supply to a Uterine Fibroid posted by Editor on November 02, 1999 at 10:45:57:
I have seen collateral flow to the uterus (with or without an anatomic variant of the UA) in about 1 patient in 50. So far I have embolized one ovarian artery in addition to all visible UAs in a total of 11 patients (and am in the midst of writing the series up).
I assume that if you embolize the ovarian artery with PVA, it infarcts the ovary. However, it is well known from the literature (especially Stancato-Pasik A, Mitty HA, Richard HM III, Eshkkar NS. Obstetric Embolotherapy: Effect on Menses and Pregnancy. Radiology 1996; 201(P):179) that the embolotherapy protocols used for acute post-partum hemorrhage do not interfere with future menstrual function or fertility.
Using this experience as a guide, I embolize the ovarian artery with large gelfoam pledgets in the proximal segment. In combination with PVA embolization of all visible UAs, this provides effective therapy, with all patients responding to therapy and no patient showing evidence of ovarian dysfunction.
One can ususally tell from the appearance/distribution/flow pattern of the UAs whether or not there is a need to specifically look for an ovarian artery supply.