Polyvinyl alcohol particles and tris-acryl gelatin microspheres for uterine artery embolization for leiomyomas: results of a randomized comparative study.
OBJECTIVE
To determine if the type of embolic material used for uterine artery embolization (UAE) for leiomyomas has an impact on short-term recovery or the effectiveness of embolization.


METHODS
One hundred patients were randomly assigned to undergo UAE with polyvinyl alcohol (PVA) particles or tris-acryl gelatin microspheres. Short-term, in-hospital medication use and pain levels were recorded. After discharge, symptom severity, temperature, and medications used were recorded daily for 1 week and symptom levels were measured for weeks 2-4. Three months after embolization, contrast material-enhanced magnetic resonance imaging examinations were evaluated blindly to determine the extent of leiomyoma infarction. Symptom and quality of life (QOL) status was determined with use of questionnaires. Analysis was completed with use of chi(2) analysis, Fisher exact tests, Student t tests, and analysis of variance as appropriate. Regression analysis was used to analyze the impact on outcome of baseline factors (other than type of embolic agent).


RESULTS
No significant differences were noted at baseline between the two treatment groups. On average, there were significantly higher volumes of tris-acryl microspheres used (9.0 mL vs 3.0 mL; P =.0001), whereas microcatheter occlusion was more common with PVA (28% vs 4%, P =.001). There were no differences in pain severity, other postprocedural symptoms, or medication use between the two treatment groups. There were also no differences in the frequency of incompletely infarcted leiomyomas, degree of improvement in symptom score, patient satisfaction, or QOL.


CONCLUSIONS
No substantive differences were detected between outcomes of embolization with PVA particles or tris-acryl gelatin microspheres.
Department of Radiology, Georgetown University Hospital, 3800 Reservoir Road NW, Washington, DC 20007-2113, USA. spiesj@gunet.georgetown.edu
James B
JB
Spies
Sandra
S
Allison
Pamela
P
Flick
Michael
M
McCullough
Kathleen
K
Sterbis
Michelle
M
Cramp
Jill
J
Bruno
Reena
R
Jha
D000180:Acrylic Resins / Q000627:therapeutic use*; D000328:Adult; D001158:Arteries; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005780:Gelatin / Q000627:therapeutic use*; D006801:Humans; D007889:Leiomyoma / Q000628:therapy*; D008875:Middle Aged; D011142:Polyvinyl Alcohol / Q000627:therapeutic use*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000628:therapy*; D014599:Uterus / Q000098:blood supply*
D000180:Acrylic Resins; C496735:trisacryl gelatin microspheres; D005780:Gelatin; D011142:Polyvinyl Alcohol