Ovarian Artery: Angiographic Appearance,Embolization andRelevance to Uterine Fibroid Embolization

Purpose: To describe the angiographicappearance of the ovarian artery and its main variations that may berelevant to uterine fibroid embolization. Methods: Theflush aortograms of 294 women who had been treated by uterine arteryembolization for fibroids were reviewed. Significant arterial supply tothe fibroid, and the origin and diameter of identified ovarian arterieswere recorded. In patients with additional embolization of the ovarianartery, the follow-up evaluation also included hormonal levels andDoppler imaging of the ovaries. Results: A total of 75ovarian arteries were identified in 59 women (bilaterally in 16 womenand unilaterally in 43 women). All ovarian arteries originated from theaorta below the level of the renal arteries with a characteristictortuous course. Fifteen women had at least one enlarged ovarian arterysupplying the fibroids. Fourteen women (14/15, 93%) presented at leastone of the following factors: prior pelvic surgery, tubo-ovarianpathology or large fundal fibroids. Conclusion: Weadvocate the use of flush aortography in women with prior tubo-ovarianpathology or surgery or in cases of large fundal fibroids. In the caseof an ovarian artery supply to the fibroids, superselectivecatheterization and embolization of the ovarian artery should beconsidered.