Uterine artery embolization with highly compressible calibrated microspheres for the treatment of uterine fibroids

Abstract

Objective: To evaluate the safety and efficacy of using highly compressible calibrated microspheres in uterine artery embolization (UAE) for the treatment of uterine fibroids. Materials and Methods: This was a prospective multicenter study. Thirty-two women with symptomatic uterine fibroids were selected for UAE between January 2019 and March 2020. The participants completed the Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaire, underwent contrast-enhanced pelvic magnetic resonance imaging (MRI), and were submitted to anti-Müllerian hormone measurement, subsequently undergoing UAE with Embosoft microspheres. After six months, the patients again completed the UFS-QOL questionnaire and underwent pelvic MRI. Results: The most common symptoms were abnormal uterine bleeding (in 81.3% of the cases), pelvic pain (in 81.3%), and compression (in 46.9%). Of the 32 patients evaluated, 12 (37.5%) had anemia due to abnormal uterine bleeding. Thirty patients completed the study. Among those patients, we observed median reductions of 21.4% in uterine volume and 15.9% in dominant fibroid volume. We identified no adverse events that could be attributed to the material itself, although there were events attributed to the UAE procedure in general. Conclusion: For the treatment of uterine fibroids, UAE using Embosoft microspheres shows satisfactory results, providing reductions in uterine and dominant fibroid volumes, with a low rate of adverse events, and improving patient quality of life, as well as demonstrating safety and efficacy.

Update on Endovascular Therapy for Fibroids and Adenomyosis

“…34 In a prospective multicenter study, microspheres showed a low rate of adverse events, reduced uterine fibroid volumes, and improved quality of life. 35 In another prospective clinical trial, 8Spheres (Suzhou Hengrui Callisyn Biomedical Technology, China), a type of conformal microsphere, has been shown to relieve heavy menstrual bleeding effectively and has no significant impact on ovarian function. 36 Embozenes microspheres (Varian, United States) are another type of tightly calibrated microsphere that can be used as an embolic agent.…”

Pelvic pain management with ultrasound-guided superior hypogastric plexus block (SHPB) after uterine artery embolization for symptomatic myomatosis

“…Visual analog scale (VAS): the initial VAS, reported immediately at the end of UAE, and the final VAS, between twelve and fourteen hours after SHPB and before discharge, were obtained. The scale was reported as mild (0-2), moderate (3)(4)(5)(6)(7), or severe (8-10) pain.…”

“…Subsequently, ischemic degeneration and regression of the myoma occur, resulting in uterine shrinkage and improvement or disappearance of symptoms such as pelvic pain, bleeding, and compression of adjacent organs 3 . Various embolizing materials have been used, such as gelatin sponge 4,5 , polyvinyl alcohol 1 , and microspheres 6 .…”