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Enhanced myometrial vascularity: tailored superselective flow-reduction uterine artery embolization for fertility
Vinicius Adami Vayego Fornazari1, Gloria Maria Salazar2, Gustavo Henrique Vieira Andrade3
1Division of Vascular and Interventional Radiology, Department of Radiology, University of Florida, College of Medicine - Jacksonville, Jacksonville, FL, 32209, USA. viniciusfornazari820@gmail.com.
Abstract:
Enhanced myometrial vascularity (EMV) is a rare, pregnancy-related hypervascular condition that can cause persistent uterine bleeding and is frequently misinterpreted as an arteriovenous malformation. Women undergoing assisted reproduction who developed symptomatic EMV after miscarriage or uterine instrumentation. Superselective flow-reduction uterine artery embolization (UAE) was performed using 2.0-2.4 F microcatheters with individualized embolic selection, microspheres for diffuse thin-walled vessels and coils or NBCA for discrete feeders. The goal was targeted flow reduction while preserving global uterine perfusion. All patients experienced complete bleeding resolution, preserved uterine morphology, and subsequently achieved successful conception through assisted reproduction. These findings support tailored, fertilitypreserving UAE as a safe and effective management strategy for symptomatic EMV.
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