Uterine artery embolisation (UAE) for symptomatic fibroids uses which embolic material as the first-line agent?

• A Polyvinyl alcohol (PVA) microspheres or calibrated trisacryl gelatin microspheres (Embosphere) ✓
• B Absolute ethanol (dehydrated alcohol)
• C Gelatin sponge (Gelfoam) pledgets
• D N-butyl cyanoacrylate (NBCA/glue)

Explanation

UAE for uterine fibroids uses calibrated microspheres — either polyvinyl alcohol (PVA) particles (500–700 μm or 700–900 μm) or trisacryl gelatin microspheres (Embosphere) — as the standard embolic agent. These particles produce distal, permanent occlusion of the uterine arterioles supplying fibroids while being large enough to spare the ovarian circulation and preserve fertility potential. Calibrated spherical particles provide more uniform and predictable occlusion than irregularly shaped particles. Absolute ethanol is used for sclerotherapy of venous malformations and renal tumour ablation. Gelfoam is temporary and appropriate for post-partum haemorrhage. NBCA glue is for AVM or GI haemorrhage embolisation.

Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.

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