Limited uterine artery embolization with tris-acryl gelatin microspheres for uterine fibroids.
OBJECTIVE
To evaluate the midterm results of limited embolization of the uterine arteries in the management of symptomatic uterine fibroids and to evaluate the efficacy and safety of limited uterine artery embolization (UAE) with use of calibrated tris-acryl gelatin microspheres in the management of symptomatic uterine fibroids.


METHODS
Twenty women (mean age, 43 years) with symptomatic uterine fibroids underwent bilateral embolization of the uterine arteries with use of calibrated microspheres. Devascularization of the fibroids was achieved and the main uterine artery was left patent in all women. Embolization was offered as an alternative to surgery in all women who had been treated unsuccessfully with medical therapy.


RESULTS
All procedures were technically successful. Microspheres 700-900 micro m in diameter were used in 14 women (70%). After a mean follow-up duration of 30.2 months (range, 24-48 mo), all women reported improvement in their symptoms, with 85% reporting complete resolution of menorrhagia at the most recent follow-up. One woman with multiple fibroids required a second embolization procedure because of persisting symptoms at 6 months. She is currently symptom-free after 48 months. In two women with submucosal fibroids, expulsion of necrotic fibroids occurred 2 and 7 months after the procedure, respectively. All women resumed normal menstruation after the procedure. One woman had a successful full-term pregnancy after embolization.


CONCLUSIONS
Early experience with UAE with use of calibrated tris-acryl gelatin microspheres indicates that it is safe and efficacious in controlling menorrhagia.
Pelage
Jean-Pierre
JP
Department of Body and Vascular Imaging, Hôpital Lariboisière, AP-HP, 2 rue Ambroise Paré, 75475 Paris Cedex 10, France. jean-pierre.pelage@lrb.ap-hop-paris.fr
Le Dref
Olivier
O
Beregi
Jean-Paul
JP
Nonent
Michel
M
Robert
Yann
Y
Cosson
Michel
M
Jacob
Dennis
D
Truc
Jean-Bernard
JB
Laurent
Alexandre
A
Rymer
Roland
R
D000328:Adult; D015901:Angiography, Digital Subtraction; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005780:Gelatin; D006801:Humans; D007889:Leiomyoma / Q000098:blood supply / Q000000981:diagnostic imaging / Q000628:therapy*; D008863:Microspheres; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011446:Prospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000628:therapy*
D005780:Gelatin