Uterine arteriovenous malformations (AVM) a rare but life-threatening condition that can lead to massive bleeding, hypovolemic shock and death. Although some patients may remain asymptomatic, the most frequent presenting symptoms are persistent menorrhagia, anemia, dysmenorrhea, dyspareunia and abdominal pain 1 .
The classic definitive treatment for this type of AVM was hysterectomy, that entailed infertility as well as many postoperative complications (intraoperative hemorrhage, venous thromboembolism, wound infection and sepsis) 1 .
However, during the past two decades the development of endovascular techniques have opened the door to a minimal invasive treatment for this disorder, being the embolization of the uterine vessels the first choice treatment in many centers.
Usually the preferred method is to perform a transarterial embolization of the uterine artery, but this may be limited by the vessel tortuosity and a transvenous approach may be needed 2 . We present the case of a congenital uterine AVM with persistent symptomatology in spite of a previous embolization of pelvic vessels, treated with coil embolization of both uterine veins.