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Legacy Good Samaritan first in Oregon to treat woman's fibroid through the wrist


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Viewing:Mary Costantino, MD, an interventional radiologist atLegacy Good Samaritan Medical Center, has become the first physician in Oregon to treat a woman’s fibroid through her wrist as opposed to the groin artery. The technically challenging procedure, known as radial uterine fibroid embolization (UFE), is performed in the northwest Portland hospital’s catheterization laboratory. It involves inserting a catheter into the radial artery located in the wrist and is guided by the interventional radiologist into the uterus. It requires no incision and uses small particles to damage and shrink the fibroids.

“This procedure is transformative for our patients,” said Dr. Costantino. “The difference of accessing the fibroid through the wrist versus the groin is like night and day for patients in terms of recovery time and pain management. My patients are showering, standing up, eating and going home earlier –– and they are very grateful for that.”

Radial access has been preferred by cardiologists for coronary interventions for a long time and has recently gained popularity across the United States for accessing the uterus. Accessing the uterus through the groin is historically how interventional radiologists have performed UFE. This method requires bed rest including having to lay flat for six hours, which can be very painful, necessitating more pain medications. UFE is an alternative to hysterectomy. The typical benefits of radial UFE include:

• Preservation of the uterus
• Discharged earlier from the hospital – sometimes same day
• Little to no blood loss
• Shorter recovery time and a faster return to work
• Less pain, which means less pain medication

Dr. Costantino performed radial UFE on Mari Bartoo, owner of a gift and art shop called Rutabaga in northeast Portland, in April 2015. By the time she had the procedure, Bartoo had been living with the fibroid for two and a half years and it had grown into the size of a grapefruit.

“I chalked it up to early menopause and was seeking eastern medicine treatments such as herbs and acupuncture,” she explained. “After it wasn’t getting any better and we took some images, my acupuncturist determined I had a fibroid.”

Bartoo’s primary care physician told her she had two options: a hysterectomy or UFE.

“At age 42, I was not ready to go into menopause and wanted it to happen more naturally,” recalled Bartoo.

That’s when she was referred Dr. Costantino who told her she was the perfect candidate for radial UFE.

“I was out of the hospital the next day and it seemed like every day was better than the last. I was able to walk around the same day as the procedure and was off pain medication within the week,” Bartoo said.

Today, Bartoo is fibroid-free and feeling better than ever.

“Because I let the fibroid go on for so long, I forgot what it was like to feel good,” Bartoo continued. “I have more energy and clarity than I have had in years. I feel like I am rediscovering myself.”

Fibroids, non-cancerous tumors that grow within the uterus, are the number one cause of hysterectomies in the United States and over 700,000 are performed each year. Fibroids are typically found in women ages 30-50 and effect 40% of women over the age of 40. They cause heavy, excessive menstrual bleeding, pelvic pain and pressure, urinary incontinence and frequency

“While hysterectomy is a very good treatment for uterine fibroids, UAE is considered equally as effective,” continued Dr. Costantino. “Radial uterine fibroid embolization should be presented as a minimally invasive option to every woman who is considering treatment for her fibroids.”

If you or a loved one is experiencing signs and symptoms of uterine fibroid tumors or have questions about this procedure, please call Dr. Costantino’s office at (503) 535.8314.
For media-related inquiries, please contact Megan Deisler at [email protected].

July 20, 2016

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I wonder how much radiation you need to get from the wrist to the uterus.
 
Did informed consent include the inability to lift anything significant for weeks? I remember a patient employed at manual labor that had heart cath through wrist and missed a month of work. No one told him beforehand about this one little difference versus the traditional approach.
 
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Did informed consent include the inability to lift anything significant for weeks? I remember a patient employed at manual labor that had heart cath through wrist and missed a month of work. No one told him beforehand about this one little difference versus the traditional approach.

Heart cath is different than UFE... tools are different, gauges of catheters are different
 
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