Acrylamido polyvinyl alcohol microspheres for uterine artery embolization: 12-month clinical and MR imaging results.
OBJECTIVE
To report the 12-month clinical and magnetic resonance (MR) imaging results of an ongoing two-center registry involving acrylamido polyvinyl alcohol (PVA) microspheres for uterine artery embolization (UAE) for leiomyomas.


METHODS
A total of 69 patients underwent UAE with 500-700-microm, 700-900-microm, and 900-1,200-mum acrylamido PVA microspheres (BeadBlock). Thirty-three patients underwent UAE with a limited embolization (protocol A) and 36 patients underwent UAE with stasis as the angiographic endpoint (protocol B). Primary objectives were clinical efficacy measured by a leiomyoma-specific quality of life (QOL) questionnaire and infarction rate of leiomyomas on early contrast agent-enhanced MR imaging. Secondary objectives were in-hospital complications, patient satisfaction, and frequency of clinical failure.


RESULTS
Bilateral embolization was technically successful in 68 of 69 patients. A significant decrease (P < .001) in symptom severity and increase in health-related QOL was observed at 3 and 12 months with no significant differences between embolization protocols. However, contrast agent-enhanced MR imaging showed a significantly lower rate of completely infarcted leiomyomas in protocol A compared with protocol B (P < .05). Early clinical failures in patients treated according to protocol A were caused by incomplete tumor infarction. Minor complications occurred in five of 69 patients. Patient satisfaction was similar between protocols.


CONCLUSIONS
Acrylamido PVA microspheres are a clinically effective and safe embolic agent for UAE. The use of 500-700-microm spheres and a limited embolization results in an unacceptably high rate of failed tumor infarction. Superior imaging results and fewer repeat interventions can be achieved with use of 700-900-microm spheres and stasis as the angiographic endpoint.
Kroencke
Thomas J
TJ
Department of Radiology, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. thomas.kroencke@charite.de
Scheurig
Christian
C
Lampmann
Leo E H
LE
Boekkooi
Peter F
PF
Kissner
Lutz
L
Kluner
Claudia
C
Weichert
Wilko
W
Hamm
Bernd
B
Lohle
Paul N M
PN
D000178:Acrylamides / Q000627:therapeutic use*; D000328:Adult; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005858:Germany; D006801:Humans; D007238:Infarction; D007889:Leiomyoma / Q000098:blood supply / Q000473:pathology / Q000628:therapy*; D018810:Magnetic Resonance Angiography; D008863:Microspheres; D008875:Middle Aged; D009426:Netherlands; D010316:Particle Size; D017060:Patient Satisfaction; D011142:Polyvinyl Alcohol / Q000627:therapeutic use*; D011446:Prospective Studies; D011788:Quality of Life; D012042:Registries; D011795:Surveys and Questionnaires; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000098:blood supply / Q000473:pathology / Q000628:therapy*; D014599:Uterus / Q000098:blood supply* / Q000473:pathology
D000178:Acrylamides; D011142:Polyvinyl Alcohol