Midterm results of uterine artery embolization using narrow-size calibrated embozene microspheres.
OBJECTIVE
To evaluate safety and efficacy of uterine artery embolization using narrow-size-range polyphosphazene-coated hydrogel microspheres (Embozene, CeloNova Biosciences, Newnan, GA).


METHODS
Between May 2006 and September 2008, a total of 121 consecutive patients (mean ± SD age 42.1 ± 5.4 years, range 30.5-51.5 years) were enrolled onto this single-center study. The primary study endpoint was safety as assessed by the society of interventional radiology (SIR) classification. The secondary endpoint was efficacy, which was based on a 1-year magnetic resonance imaging study and relief of symptoms documented by the Medical Outcomes Study 36-Item Short-Form Health Survey questionnaire over a 2-year interval.


RESULTS
The mean ± SD diameter of the dominant fibroid was 6.4 ± 2.6 (range, 2.9-13.9) cm and the mean volume 137.2 ± 245.1 (range, 5.3-1184) ml. Most patients had multiple fibroids with 11% more than 10. A total of 240 of 242 interventions were completed as planned, a technical success rate of 99.2%. According to the SIR classification, one type A, eight type C, and one type D complication occurred. Total devascularization was noted in 96% (116 of 121) of dominant fibroids. Volume decrease was 4% at 2 weeks, 52% (P < 0.001) at 3 months, 78% (P < 0.001) at 6 months, and 91% at 12 months (P < 0.001). The latter difference was statistically significant (P = 0.007). A total of 92% had improved hypermenorrhea at 1 year and 94% at 2 years. Dysmenorrhea was improved in 96% at 1 year and in 95% at 2 years. The overall health status score was 60.4 ± 26.2 points at baseline and 96.9 ± 3.8 after 1 year (P = 0.0019).


CONCLUSIONS
Uterine artery embolization with Embozene microspheres is a safe procedure. Its efficacy is demonstrated by high fibroid devascularization and volume reduction rates and significant improvements of clinical symptoms and quality-of-life scores during follow-up.
Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany.
Ulrike
U
Stampfl
Boris
B
Radeleff
Christof
C
Sommer
Sibylle
S
Stampfl
Angelika
A
Dahlke
Nadine
N
Bellemann
Hans-Ulrich
HU
Kauczor
Goetz M
GM
Richter
D000328:Adult; D005260:Female; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate / Q000627:therapeutic use*; D007889:Leiomyoma / Q000473:pathology / Q000628:therapy*; D018231:Leiomyomatosis / Q000473:pathology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008863:Microspheres; D008875:Middle Aged; D009943:Organophosphorus Compounds / Q000627:therapeutic use*; D011108:Polymers / Q000627:therapeutic use*; D016896:Treatment Outcome; D055357:Uterine Artery Embolization / Q000379:methods*
D009943:Organophosphorus Compounds; D011108:Polymers; C108974:poly(phosphazene); D020136:Hydrogel, Polyethylene Glycol Dimethacrylate