ABSTRACT

Objective:

To present the preliminary results of a feasibility study performed to determine the value of a mobile interventional radiology unit used to promote a uterine embolization program for low-income patients.

Methods:

Forty patients with symptomatic fibroids were treated with uterine embolization. Procedures were performed in four public hospitals in the metropolitan area of Sao Paulo. This study was approved by the institutional research ethics committee and all patients signed an informed consent form. A mobile interventional radiology unit, named ANGIOMOVEL, was conceived and implemented utilizing a small truck to transport one mobile C arm, one radiological table, protection aprons and a small trolley containing specific supplies for the procedures. The ANGIOMOVEL team consisted of two interventional radiologists, one nurse, one driver and one assistant. The unit visited one hospital per week during a three-month period. Patient inclusion was contingent upon several factors, such as evaluation by a trained gynecologist, completion of a pelvic MRI, routine serological laboratory tests and completion of a quality of life questionnaire (QOL). Outcomes, MRI and QOL were evaluated. Data obtained after 12 weeks were collected and analyzed.

Results:

Technical success was achieved in 100% of cases, with a mean procedure time of 43 minutes and a mean fluoroscopic time of 24 minutes. The mean hospital stay was 1.07 day and the mean time for recovery and return to normal activities was 10 days. After 12 weeks, 36 (90%) of patients noticed improvement of their symptoms and 4 (10%) did not notice any improvement. Thirty-eight patients (95%) were satisfied or very satisfied and 39 (97.5%) said they would recommend the procedure. Pre- and post-procedure magnetic resonance imaging analysis showed that complete fibroid ischemia was achieved in 92.5% of cases with a mean uterine volume reduction of 38% and a mean fibroid volume reduction of 52%. Health-related quality of life scores showed improvement, increasing from 39.30 before the treatment to 79.62 points after therapy.

Conclusions:

The initial results indicate that using a Mobile Interventional Radiology Unit is feasible, efficient and safe to develop a successful uterine fibroid embolization program providing care to the underserved patient community.

Keywords:
Myoma/radiotherapy; Radiology, interventional; Mobile health units; Mobile health units/supply & distribution; Uterine artery embolization; Uterine artery embolization/utilization; Uterine artery embolization/economics; Social responsibility; Quality of life; Hospitals, public; Women's health services; Women's health services/supply & distribution; Women