Comparison of particle penetration with non-spherical polyvinyl alcohol versus trisacryl gelatin microspheres in women undergoing premyomectomy uterine artery embolization.
OBJECTIVE
The purpose of this study was to compare the depth of vascular penetration of non-spherical polyvinyl alcohol (PVA) versus trisacryl gelatin microspheres (MS) in women undergoing uterine artery embolization (UAE) immediately before transabdominal myomectomy.


METHODS
A total of 17 patients who had been referred for embolization before myomectomy underwent bilateral uterine artery embolization using either 355-500 microm PVA (group A) or 700-900 microm MS (group B). The depth of penetration of the particles was assessed by identifying their presence and location in the resected specimen.


RESULTS
Of the 17 women enrolled in this study, 10 were in group A and 6 in group B. One woman underwent embolization using both types of particle and was excluded from the analysis. Embolic particles were significantly (p = 0.048) more frequently located within the fibroid (4/6, 67%) in Group B than Group A (1/10, 10%). Particles were also identified in the perifibroid tissues in 4/6 (67%) in Group B and 4/10 (40%) in Group A, with no statistical difference. There were no procedural complications.


CONCLUSIONS
MS particles (700-900 microm) penetrate significantly deeper into leiomyomata compared with non-spherical PVA (355-500 microm). MS may therefore confer advantages in UAE, as they may more specifically target the fibroid, allowing an earlier end-point to embolization and minimizing ischaemic damage to normal myometrium and ovaries.
Chua
G C
GC
Department of Radiology, St George's Hospital, London, UK.
Wilsher
M
M
Young
M P A
MP
Manyonda
I
I
Morgan
R
R
Belli
A-M
AM
D000180:Acrylic Resins / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000328:Adult; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005780:Gelatin / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D007889:Leiomyoma / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D011142:Polyvinyl Alcohol / Q000493:pharmacokinetics / Q000627:therapeutic use*; D011446:Prospective Studies; D014594:Uterine Neoplasms / Q000601:surgery / Q000628:therapy*
D000180:Acrylic Resins; C496735:trisacryl gelatin microspheres; D005780:Gelatin; D011142:Polyvinyl Alcohol