Dextran uterine artery embolization to treat fibroids.
OBJECTIVE
To analyze the technical aspects of uterine artery embolization with dextran microspheres and to evaluate the effectiveness of this technique as the primary treatment of uterine fibroids in a series of 38 patients.


METHODS
Thirty-eight volunteers (age range, 24-48 years; mean, 37.2 years) with symptoms caused by uterine fibroids (menorrhagia, mass-related symptoms, and pelvic pain) were randomly included in this study. The fibroids were single in 32 patients and multiple in 6 patients. According to the tumor location, subserous fibroids were found in 4 patients and interstitial or submucosal fibroids in 34. Tumor size was from 2 to 10.9 cm in diameter. We performed embolization with a single Headhunter catheter using the right-femoral artery approach, injection of dextran microspheres (225-450 micro m), and an absorbable gelatin sponge. Follow-up included clinical and sonographic examinations at one-month intervals for 6 months.


RESULTS
Embolization was successfully performed in all patients. Post-procedural pain control was good in 35 (92%) patients. In most patients, symptoms were improved at 3 months (36/38, 95%). Clinical failure of the treatment occurred in only 2 patients (2/38, 5%). Progressive reduction in leiomyoma size was revealed during sonographic follow-up, and the reduction rate at the sixth month after embolization was 68%. The tumor had vanished in five submucosal fibroid patients. Histopathological tests showed that the tumor was degenerative as fibrosis and hyalinosis.


CONCLUSIONS
Uterine artery embolization with dextran microspheres is a micro-invasive method for the treatment of uterine fibroids. It is clinically effective in most patients and induces a progressive reduction in the size of fibroids. Based on this study, we believe that this new technique is much more suitable for submucosal fibroids with massive menorrhagia.
Wang
Jie
J
Interventional Radiological Section, Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China. ajwang@public1.ptt.js.cn
Zhang
Guoying
G
Shi
Haibin
H
Feng
Yaoliang
Y
Wang
Weidong
W
Wang
Yongli
Y
Liu
Jiayin
J
D000328:Adult; D003911:Dextrans / Q000008:administration & dosage*; D004621:Embolization, Therapeutic / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007889:Leiomyoma / Q000628:therapy*; D008875:Middle Aged; D014594:Uterine Neoplasms / Q000628:therapy*; D014599:Uterus / Q000098:blood supply
D003911:Dextrans