Groin vs. Wrist: Understanding the Two Access Points for Uterine Fibroid Embolization (UFE)

Apr 14, 2024
Wrist band work after radial access
Uterine Fibroid Embolization (UFE) can be performed by accessing the radial artery in the wrist or the femoral artery at the groin, or top of the leg. We break down the similarities and differences between these two ways to do the same procedure.

Uterine fibroid embolization (UFE) offers a minimally invasive alternative to surgery for women with symptomatic by fibroids. The procedure involves gaining access to the blood vessel with a needle puncture and from within the blood vessel advancing  a small thin tube (catheter) into the blood vessels that supply nutrition to the fibroids. This is done through the injection of small gel particles.

Within this technique, however, lies a choice: the entry point into a blood vessel for the catheter that delivers the embolization material. Traditionally, the femoral artery in the groin (leg) has been the go-to approach. Recently – the radial artery in the wrist (arm) – is gaining traction. Let's delve into the pros and cons of each approach to help you understand which might be a better fit for you.

The Groin (Femoral Artery) Approach:

  • Experience: This approach has been around longer, with a well-established safety profile and a wealth of data supporting its effectiveness.
  • Success Rate: Studies show high success rates in fibroid shrinkage and symptom reduction.
  • Familiarity: Most doctors are highly experienced with the femoral approach.

However, there are some downsides to consider:

  • Discomfort: The puncture site in the groin can be more uncomfortable and requiring bed rest post-procedure.
  • Bruising: Bruising at the puncture site is uncommon and but can occur and may take some time to resolve.
  • Activity Restrictions: Lifting of heavy objects restrictions may be in place for a while after the procedure.

The Wrist (Radial Artery) Approach:

  • Comfort: The puncture site in the wrist allows patients to walk immediately after the procedure.
  • Less activity limitations : Less limitations as far as lifting heavy things after procedure.
  • Can wear undergarments: Women may potentially be able to keep their undergarments on during the procedure which can be desired especially for women who have menstrual bleeding at the time.

While the wrist approach offers these advantages, it's important to be aware of its limitations:

  • Newer Technique: As a newer approach, there's still ongoing research to establish a long-term data track record.
  • Sensitive area: As the access is by the hand Usually left), if there is bruising or injury to that area, it may be more sensitive in daily activities after the procedure as compared to the groin.
  • Anatomic Considerations: The radial artery anatomy in some patients might not be suitable for this approach.

Choosing the Right Approach for You

Ultimately, the best access point for your UFE depends on your individual circumstances. Here are some factors to consider when discussing options with your doctor:

  • Your comfort level: If minimizing post-procedural discomfort is a priority, the wrist approach might be more appealing.
  • Your doctor's experience: Ensure your doctor is comfortable and experienced with the access point you're leaning towards.
  • Your anatomy: Certain anatomical variations may make the wrist approach unsuitable.

Open Communication is Key

During your consultation, discuss your concerns and preferences openly with your doctor. They can assess your medical history, fibroids, and anatomy to guide you towards the most suitable access point for a successful UFE.