Category: Peripheral Intervention

Two in three women will develop fibroids at some point in her life. Uterine fibroids are small, noncancerous growths that form on the wall of the uterus. Although benign, and while many women may not experience complications, for some, fibroid symptoms can be devastating. Worse, information on treatment options is not always made readily available, and many patients are led to believe that the only solution is major surgery—like a hysterectomy.

Meet Malin Florentzson, a woman who had her life turned upside down when doctors informed her that removing her uterus would be the best treatment for her heavy menstrual bleeding and pain.

“Being 28, I found it really shocking that they said it was absolutely the only option,” reflected Malin. “I decided not to do it and learn how to live with my problems.”

Malin gave it her all, but unfortunately, her symptoms caught up. When her pain and fatigue worsened to the point where she collapsed at an airport, she knew she needed to seek a second opinion. That’s when she discovered the source of her complications: fibroids.

As an employee of Merit Medical, Malin was familiar with uterine fibroid embolization (UFE). An alternative method of treating fibroids, UFE allows patients to preserve the uterus by stopping blood flow to the fibroids, which causes them to shrink—thus relieving symptoms.

For Malin, this presented an ideal solution. “I don’t want to remove an organ if I don’t absolutely have to,” she said. “I looked for someone to help me understand if I was a good candidate for UFE or not.”

After an MRI confirmed that UFE may be right for her condition, Malin scheduled an appointment with her gynecologist and interventional radiologist. And when the hospital placed the order with Merit for Embosphere® Microspheres—the tiny particles used to block blood supply to fibroids, causing them to shrink? It was Malin who took the call. “That was quite funny,” she remarked.

Malin made a full recovery from the successful UFE procedure. With her symptoms gone or significantly reduced, she was able to get back to the activities she enjoyed prior to developing fibroids. “It’s like a new life,” she said.

These days, Malin spends her time advocating for increased awareness of UFE as a treatment option to help reduce the stigma around talking about fibroids. “Who would I be if I couldn’t stand up and tell my story? We have to start understanding and listening to each other.”

Merit Medical is proud to support health at every stage, committed to helping patients live life to the fullest. For Women’s Health Week, meet Andrea Peterson—an advocate for adventurous women everywhere and patients who refuse to let a diagnosis slow them down.

Andrea Peterson’s peaceful, rural life came to an abrupt halt when she received a grim diagnosis: cancer. Thankfully, she didn’t let this stop her. Instead, she saw it as an opportunity to reinvent her life. With fresh determination to not only survive but to thrive, Andrea began to chase every dream she’s had.

“I just started living,” Andrea explained, recounting how her new outlook motivated her to become a firefighter, pilot, pianist, world-traveler, and more.

“It’s a beautiful world. I met people and had experiences that ordinary people don’t.”

Even when her cancer spread, Andrea didn’t lose hope. Her doctor recommended the placement of a catheter to drain accumulated fluid from her pleural cavity and relieve uncomfortable symptoms. Not wanting to be held back by bulky bottles, Andrea requested the Aspira® Drainage Bag.

For Andrea, this was only her next great adventure. Because the Aspira system is designed to provide patients with maximum freedom, Andrea remarked, “I can still live and do anything I want. Every time we get a delivery of Aspira, it’s more life, more freedom, and more adventures.”

Andrea’s most recent expedition took her to Antarctica, a dream she’s pursued since childhood. And at her side? Her “freedom friend,” the Aspira bag.

Watch her full story.

July is Fibroid Awareness Month, a time we recognize a health issue affecting as many as 80 percent of women before they reach the age of 50.¹ Fibroids, or muscular tumors that develop in the wall of the uterus, are more common among African Americans than white, Hispanic, or Asian women.¹ Generally noncancerous, they can range in size from a small apple seed to a large grapefruit.²

Although some women with fibroids have no symptoms, others may experience abdominal pain, frequent urination, enlargement of the lower abdomen, and heavy menstrual bleeding.² Despite its prevalence and severe symptoms, the condition is seldom discussed. To change that, we talked with Carmen McKeever, who was first diagnosed with uterine fibroids during an appointment with her gynecologist.

At first, Carmen didn’t think anything of her fibroids, but a few years later, she developed serious symptoms, including heavy, long, painful periods—including a devastating cycle that caused her to bleed for an entire month straight.

“Fibroids really impacted my everyday life.” Carmen explained. “Professionally, I am a nurse. At my facility, our uniform is white scrubs. So you can imagine, every month it was like a nightmare.”

During her period, Carmen had to equip herself with an “arsenal” to make it through the day and avoid accidents. On any given day, she admitted to needing a super absorbency tampon, two ultra-absorbency maxi-pads, a Depend® adult diaper, and Spanx® to hold it all together.

All of this wasn’t enough, as Carmen explained. “I also had all that stuff in my bag just in case I had to change, which was about every hour.”

Unable to tolerate going through life like this any longer, Carmen explored fibroid treatments. But like other women seeking an alternative to a complete hysterectomy, Carmen faced resistance when meeting with doctors.

“The help I received from medical professionals was—operate. Hysterectomy. That was it. I just felt like I was being dismissed,” she recalled with emotion. “I oftentimes felt like it was my fault that I had fibroids. That I was wasting people’s time because I was trying to figure out what I was going to do, and not have a hysterectomy, and that was the only answer I was getting.”

After searching and getting nowhere, Carmen finally learned about uterine fibroid embolization (UFE) from an acquaintance who also suffered from fibroids. After attending a free UFE hospital seminar presented by Dr. John Lipman, a vascular and interventional radiologist and fibroid specialist at Atlanta Interventional Institute, she was intrigued.

During the UFE procedure, a catheter is carefully inserted into an artery in the wrist or groin area and guided to the uterine arteries that supply fibroids with blood. Tiny particles are injected to cut off blood flow to the fibroids, causing them to shrink. The treatment is generally performed as an outpatient procedure and completed within about one hour.

Upon meeting with Dr. Lipman and learning of UFE, Carmen felt at ease. “He made sure that I had all the information and that I was well-informed, so I could make a logical decision.”

Carmen decided to get UFE and felt it was the best decision. “My pain [during recovery] was nothing compared to the menstrual cramps that I experienced every month,” she described. After resting for four days, she returned to work just one week after the procedure.

Carmen’s persistence paid off, and she avoided an unnecessary hysterectomy. “I’m hoping that I can use this platform to let other women know about UFE,” she emphasized. “Women who are afraid to wear white pants and who feel a gush of blood flowing every time they get up from their seat. Who pray they have not messed up their seat at work or messed up the back of their pants or their nice skirt when they go out to dinner or they go to church. I hope that by doing this, I let other women know—just like I found out—that there is an alternative.”

Hear from more patients who have overcome fibroids with UFE and now live full, healthy lives.

The above information should not be construed as providing specific medical advice but rather to offer readers information to better understand their lives and health. It is not intended to provide an alternative to professional treatment or to replace the services of a physician.

REFERENCES

1. U.S. Food & Drug Administration. “Knowledge and News on Women: Fibroid Awareness Month”. July 1, 2021. https://www.fda.gov/consumers/knowledge-and-news-women-owh-blog/knowledge-news-women-fibroid-awareness-month
2. U.S. Department of Health and Human Services. Office of Women’s Health. “Uterine Fibroids”. February 19, 2021. https://www.womenshealth.gov/a-z-topics/uterine-fibroids

June is Men’s Health Month, a time we use at Merit to raise awareness about conditions that affect men, encouraging individuals to take control of their health and live their best lives. We do this by providing the products and education needed to help physicians and patients learn more about life-changing procedures. One such procedure called prostatic artery embolization (PAE) is a minimally invasive approach to treating bothersome urinary symptoms caused by an enlarged prostate, also known as benign prostatic hyperplasia (BPH).

We sat down with Larry Sago, a patient who underwent PAE, to hear his story and better understand how life changing the procedure can be.

“The difference is like night and day,” Larry said, describing his life before and after prostatic artery embolization (PAE).

Larry’s journey began when he was diagnosed with BPH. A common condition, about half of all men in their 50s develop BPH—a statistic that increases with age.¹ Although non-cancerous, BPH can cause a host of bothersome urinary symptoms, including feelings of urinary urgency, weak or interrupted urine stream, and urinary frequency.

For months prior to undergoing PAE, BPH began to take a major toll on Larry’s life. He started experiencing urine retention and found at times he couldn’t go at all. In pain, Larry resorted to driving himself to the ER to get a Foley catheter inserted to temporarily relieve the pressure.

For many men like Larry who suffer from BPH, the first line of treatment is commonly prescription medications to treat the symptoms, but these are occasionally ineffective and often have less-than-desirable side effects. After trying medications, Larry found his symptoms couldn’t be controlled any longer and continued to worsen. “My urologist told me TURP [transurethral resection of the prostate] was about the only answer.”

TURP is a surgical procedure that cuts away the prostate tissue that blocks the flow of urine. While very effective in improving urination, it can be associated with complications like bleeding, urinary leakage, and sexual side effects. The bleeding risks become more concerning the larger the prostate becomes.

Not wanting to have surgery or to risk having the complications associated with TURP, Larry researched non-surgical treatment options online but wasn’t finding much. As luck would have it, Larry one day found an article by University of North Carolina (UNC) Clinical Assistant Professor of Radiology Dr. Ari Isaacson discussing minimally invasive PAE at the UNC Health Care System’s Center for Heart and Vascular Care.

“I emailed Dr. Isaacson as soon as I read about [PAE],” Larry recalled. “Amazingly, within half an hour he’d written me back asking for my phone number to further talk about the procedure. He called me and communicated all aspects of [PAE] very clearly.” Liking what he heard, Larry drove from Atlanta to Chapel Hill to meet with Dr. Isaacson. Once a biopsy cleared him of prostate cancer, Larry was able to undergo the procedure as part of a clinical trial.

“PAE results in shrinking and softening of the prostate which allows for urine to flow through easier, ultimately reducing urinary symptoms,” Dr. Isaacson explained. “Some of the advantages of PAE are that it is performed as an outpatient procedure, and the recovery time is quick. In most cases, no Foley catheter is required. PAE also has very little chance of affecting sexual function. In some cases, sexual function is even improved after patients are able to stop taking BPH medications.”

Post-PAE, Larry describes the procedure as easy with no pain or bleeding. Afterward, he was able to go back to his hotel room in Chapel Hill, spend the night, and drive home to Atlanta the next day. “For about a week, my former BPH symptoms returned, but they were briefer and milder this time. Once they went away, I felt like I was 20 years old again!”

PAE not only resulted in clinical improvements, it also gave Larry something priceless—his life back.

“I literally don’t think about the symptoms I used to struggle with,” Larry said. “I can go play golf without having to worry about going to the bathroom in the middle of the golf course!”

“I’m so pleased for Larry,” Dr. Isaacson noted. “His case demonstrates how effective this procedure can be. Many PAE patients can enjoy improved urination for years following the procedure.”

Feeling truly fortunate to have been a candidate for PAE, Larry said the only thing he would’ve done differently was have the procedure sooner. “If this treatment had been available, I would’ve done it years earlier. I simply hope there’s more awareness so that others can experience the boost in quality of life and long-term health that I did.”

Explore other patient testimonials and learn more about PAE.

At Merit, our mission is to improve the lives of people, families, and communities around the globe. If Larry’s story resonated with you, and you’re experiencing bothersome symptoms from BPH, talk to your doctor today to see if PAE might be an option for you.

The above information should not be construed as providing specific medical advice but rather to offer readers information to better understand their lives and health. It is not intended to provide an alternative to professional treatment or to replace the services of a physician.

REFERENCES

1. Urology Care Foundation. (n.d.). What Is Benign Prostatic Hyperplasia (BPH)? Retrieved from http://www.urologyhealth.org/urologic-conditions/benign-prostatic-hyperplasia-(bph)/

Every July, our team at Merit Medical recognizes Fibroid Awareness Month as a time to bring attention to a very common yet under-discussed condition that will affect most women at some point in their lifetime.

We do this by supporting a minimally invasive fibroid treatment called uterine fibroid embolization (UFE), also called uterine artery embolization (UAE), through a portfolio of embolotherapy products we offer.

To shed light on the performance of UFE embolic agents and to help physicians ensure women receive the best fibroid treatment experience possible, a randomized controlled trial by Han et al. compared post-UFE pain using nonspherical polyvinyl alcohol (PVA) particles versus Merit Medical’s Embosphere® Microspheres.

Published in Radiology, the study enrolled 54 women with fibroids (mean age, 44 ± 4 years [standard deviation]) and assigned UFE treatment with either nonspherical PVA (355–550 μm) or Embosphere (500–700 μm). There were 27 women in each group, and both participants and investigators collecting data were blinded to the embolic material used. Women with concomitant disease (e.g., adenomyosis) were excluded from the study.

Both groups were given fentanyl-based intravenous patient-controlled analgesia within the first 24 hours after UFE as well as rescue analgesics. The investigators measured neutrophil-to-lymphocyte ratio to assess inflammatory response, and contrast-enhanced MRI was performed 1 day after the procedure to evaluate dominant fibroid necrosis and ischemia of normal myometrium. Symptom severity score and health-related quality-of-life score were assessed before and 3 months after UFE.

Results showed that pain scores and fentanyl dose were not different during the first 24 hours, but the use of rescue analgesics was higher in the PVA group (33% vs 11%; P = 0.049). After embolization, symptom severity score and health-related quality-of-life score were not different between groups (symptom severity score: 16 [interquartile range, 6–22] for PVA vs 19 [interquartile range, 9–34] for Embosphere, P = .45; health-related quality-of-life score: 93 [interquartile range, 80–97] for PVA vs 89 [interquartile range, 84–96] for Embosphere, P = .41).

In addition, changes in neutrophil-to-lymphocyte ratio from before to 24 hours after UFE were greater in the PVA group (3.9 [interquartile range, 2.7–6.8] compared to the Embosphere group (2.5 [interquartile range, 1.5–4.6]; P = .02). Rates of complete dominant fibroid necrosis were not different between groups, but transient global uterine ischemia of normal myometrium was more frequent in the PVA group (44% vs 15%; P = .04).

Watch How UFE Works

Fibroids (also known as uterine fibroids, leiomyomas, and myomas) are non-cancerous tumors that grow within the muscle tissue of the uterus. Although some fibroids cause no symptoms at all, common symptoms can include excessive menstrual bleeding, pelvic pain and pressure, and frequent urination. Depending on the size and location of the fibroids, other symptoms can include anemia, leg pain, pain during sexual intercourse, constipation, and an enlarged abdomen. Up to 80% of women develop fibroids by the time they reach age 50.

Approximately, 600,000 hysterectomies are performed in the US each year, with fibroids listed as the most common reason. A report by the Society of Interventional Radiology found that 1 in 5 women believe hysterectomy is the only treatment option for fibroids and that 44% of women with fibroids have never heard of UFE. Although hysterectomy is a treatment for fibroids, there are many other treatment options available, many of which are minimally invasive.

To encourage women to seek out all treatment options and help physicians educate patients, we offer an educational patient-awareness site called Ask4UFE with information about treatment options—with focus on UFE—as well as patient and physician testimonials and researched blog entries.

Join us in recognizing July as Fibroid Awareness Month. We look forward to working together to increase awareness surrounding the condition, helping to provide the best resources, products, and care for patients worldwide.

Before using, refer to Instructions for Use (IFU) for indications, contraindications, warnings, precautions, and directions for use.

ARTICLE REFERENCE
Han K et al. 2020. “Nonspherical Polyvinyl Alcohol Particles verusus Tris-Acryl Microspheres.” Radiology 298, no. 2 (Feb): 458–465. PMID: 33350893.