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Initial experience of uterine fibroid embolization using porous gelatin sponge particles.

Abstract
The purpose of this study was to prospectively assess the safety and effectiveness of uterine artery embolization (UAE) using porous gelatin particle (PGP; Gelpart; Asuterasu, Tokyo, Japan) for symptomatic uterine fibroids. Twenty-five consecutive premenopausal women underwent UAE with PGP. The angiographic end point of embolization was near stasis of the ascending uterine artery. Pelvic magnetic resonance imaging (MRI) was obtained before and after the procedure. Complications were assessed. The outcomes of technique, infarction rates of all fibroid tissue after UAE with contrast-enhanced MRI, change in symptoms and quality of life using serial Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaires, and additional interventions were evaluated. Bilateral UAE was successfully performed in all patients. Enhanced MRI 1 week after UAE showed that 100% infarction of all fibroid tissue was achieved in 65% (15 of 23) of patients; 90-99% infarction was achieved in 35% (8 of 23) of patients. Mean follow-up was 12 months (range 1-20). Symptom and QOL scores at baseline were 47.2 and 61.7, respectively. Both scores significantly improved to 26.3 (P<0.001) and 82.4 (P<0.001) at 4 months and to 20.4 (P<0.001) and 77.6 (P<0.001) at 1 year, respectively. No additional gynecologic interventions were performed in any patient. There were no major complications. Minor complications occurred in two patients. UAE using PGP is a safe and effective procedure and shows that outcomes after UAE, as measured with enhanced MRI and UFS-QOL questionnaires, seem comparable with those of UAE using other embolic agents. PGP is a promising embolic agent used for UAE to treat symptomatic uterine fibroids. Further comparative study between PGP and other established embolic agents is required.
AuthorsTetsuya Katsumori, Toshiyuki Kasahara, Minori Oda, Tomoya Kotani
JournalCardiovascular and interventional radiology (Cardiovasc Intervent Radiol) Vol. 34 Issue 3 Pg. 513-21 (Jun 2011) ISSN: 1432-086X [Electronic] United States
PMID20574795 (Publication Type: Journal Article)
Chemical References
  • Contrast Media
  • Iopamidol
  • Gadolinium DTPA
Topics
  • Adult
  • Angiography
  • Contrast Media
  • Female
  • Fluoroscopy
  • Follow-Up Studies
  • Gadolinium DTPA
  • Gelatin Sponge, Absorbable (therapeutic use)
  • Humans
  • Iopamidol
  • Leiomyoma (diagnosis, therapy)
  • Magnetic Resonance Imaging
  • Middle Aged
  • Pain Measurement
  • Premenopause
  • Prospective Studies
  • Quality of Life
  • Surveys and Questionnaires
  • Treatment Outcome
  • Uterine Artery Embolization (adverse effects, instrumentation, methods)
  • Uterine Neoplasms (diagnosis, therapy)

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