{"paper_id":"771c1554-795e-4305-97bc-9ace5150ef05","body_text":"Abstract\nThe aim of this study is to evaluate the use of a 4F Rösch inferior mesenteric (RIM) catheter for pelvic embolization procedures. Between October 2000 and January 2006, 364 patients (357 female, 7 male; age: 23–67 years) underwent embolization of various pathologies [uterine fibroids (n = 324), pure adenomyosis of the uterus (n = 19), postpartum hemorrhage (n =1), traumatic or postoperative hemorrhage (n = 9), bleeding related to cervical cancer (n =7), AV malformation of the uterus (n = 2) and high-flow priapism (n = 2)] at a single institution. In all cases, bilateral catheterization was primarily attempted with the use of a 4F hook-shaped braided endhole catheter (Rösch-Inferior-Mesenteric, RIM-Catheter, Cordis, Miami, FL). Frequency of initial failure to catheterize the vascular territory of interest and carry out the embolization were recorded and the types of difficulty encountered were noted.\nCatherization of the main stem of the vessel territory of interest with the use of a unilateral femoral approach and the 4F RIM catherer was successful in 334/364 (91.8%) the embolization cases. Bilateral catheterization of the internal iliac arteries using a single common femoral artery access and the 4F RIM catheter was achieved in 322/364 (88.5%) patients. In 12/364 (3.3%) patients, a contralateral puncture was performed and the same 4F catheter was used. In 28/364 (7.7%) cases the 4F RIM catheter was exchanged for a catheter with a cobra-shaped or sidewinder configuration. The 4F RIM catheter is a simple and valuable alternative to catheters and techniques commonly employed for pelvic artery embolization.\nSimilar content being viewed by others\nReferences\nGomez-Jorge J, Keyoung A, Levy EB, et al. (2003) Uterine artery anatomy relevant to uterine leiomyomata embolization. Cardiovasc Intervent Radiol 26: 522–527\nWorthington-Kirsch RL, Andrews RT, Siskin GP, et al. (2002) II. Uterine fibroid embolization: technical aspects. Tech Vasc Intervent Radiol 5: 17–34\nWaltman AC, Courey WR, Athanasoulis C, et al. (1973) Technique for left gastric artery catheterization. Radiology 109: 732–734\nPelage JP, Soyer P, Le Dref O, et al. (1999) Uterine arteries: Bilateral catheterization with a single femoral approach and a single 5-F catheter. Radiology 1210: 573–575\nShlansky-Goldberg R, Cope C (2001) A new twist on the Waltman loop for uterine fibroid embolization. J Vasc Intervent Radiol 12: 997–1000\nBrunereau L, Herbreteau D, Gallas S, et al. (2000) Uterine artery embolization in the primary treatment of uterine leiomyomas: Technical features and prospective follow-up with clinical and sonographic examinations in 58 patients. Am J Roentgenol 175: 1267–1272\nHovsepian DM, Siskin GP, Bonn J, et al. (2004) Quality improvement guidelines for uterine artery embolization for symptomatic leiomyomata. Cardiovasc Intervent Radiol 27: 307–313\nSmeets AJ, Lohle PN, Vervest HA, et al. (2006) Mid-term clinical results and patient satisfaction after uterine artery embolization in women with symptomatic uterine fibroids. Cardiovasc Intervent Radiol 29: 188–191\nHehenkamp WJ, Volkers NA, Birnie E, et al. (2006) Pain and return to daily activities after uterine artery embolization and hysterectomy in the treatment of symptomatic uterine fibroids: results from the randomized EMMY trial. Cardiovasc Intervent Radiol 29: 179–187\nRazavi MK, Wolanske KA, Hwang GL, et al. (2002) Angiographic classification of ovarian artery-to-uterine artery anastomoses: Initial observations in uterine fibroid embolization. Radiology 224: 707–712\nHo SS, Cowan NC (2005) Uterine artery embolisation for uterine fibroids using a 4F Rosch inferior mesenteric catheter. Eur Radiol 15: 1168–1172\nSpies JB (2003) Uterine artery embolization for fibroids: Understanding the technical causes of failure. J Vasc Intervent Radiol 14: 11–14\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nKroencke, T.J., Kluner, C., Hamm, B. et al. Use of the 4F Rösch Inferior Mesenteric Catheter in Embolization Procedures in the Pelvis: A Review of 300 Cases. Cardiovasc Intervent Radiol 30, 268–272 (2007). https://doi.org/10.1007/s00270-006-0192-7\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00270-006-0192-7","source_license":"public-domain-us","license_restricted":false}