Provision of a mobile uterine artery embolization service to medically underserved areas in Brazil.

PURPOSE: To determine the feasibility, efficacy, and safety of a mobile uterine artery embolization (UAE) program for patients in medically underserved, socioeconomically deprived areas.

MATERIALS AND METHODS: One hundred women with symptomatic uterine leiomyomas were treated with UAE. A small truck containing a mobile c-arm and all needed supplies visited one hospital per week during a 6-month period. Four public hospitals were visited in rotation. Pre- and postprocedural magnetic resonance (MR) imaging and validated quality of life (QOL) questionnaires were obtained, and procedural details and complications were recorded.

RESULTS: Technical success was achieved in 97 of 100 women. Mean procedure time was 41 minutes (range, 15-140 min) and mean fluoroscopy time was 17 minutes (range, 6-45 min). Mean hospital stay was 1.03 days (range, 1-3 d) and mean time to resumption of normal activities was 8.2 days (range, 2-20 d). At 12 weeks, 88% of patients noted symptomatic improvement and 98% stated they would recommend the procedure to other women. Complete tumor ischemia was seen on postprocedural MR imaging in 92% of women, with a mean uterine volume reduction of 36.3% (range, -4.3% to 65%) and a mean tumor volume reduction of 57.1% (range, -23.4% to 95.8%). Health-related QOL scores increased from 41.4 points before UAE to 81.2 points at 12 weeks and 85.3 points at 1 year after UAE. Complications were recorded in seven women (7%): three puncture site hematomas, three readmissions for pain control, and one case of leiomyoma passage.

CONCLUSIONS: A mobile interventional radiology unit is a feasible, efficient, and safe method to provide UAE to an underserved patient community. Outcomes and complications are similar to published results from centers with conventional angiographic facilities.