Comparison of Four Embolic Materials at Uterine Artery Embolization by Using Postprocedural MR Imaging Enhancement

Abramowitz, Steven D.; Israel, Gary M.; McCarthy, Shirley; Pollak, Jeffrey; White, Robert I.; Tal, Michael

doi:10.1148/radiol.2502080574

Cited by 35 publications

(24 citation statements)

References 12 publications

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“…Procedural factors identified that may minimize pain after UAE include selection to avoid bilateral UAE among patients with limited fibroid disease [6], type of embolic material used, Contour SE requiring less opioid analgesia compared to Embosphere/Embosphere Gold [7,8] and the use of preemptive analgesic, anti-inflammatory and antiemetic medications.…”

Section: Introductionmentioning

confidence: 99%

A Randomized, Double-Blind, Placebo-Controlled Study of Preemptive Oral Oxycodone with Morphine Patient-Controlled Anesthesia for Postoperative Pain Management in Patients Undergoing Uterine Artery Embolization for Symptomatic Uterine Fibroids

Konstantatos

Kavnoudias

Stegeman

et al. 2014

Cardiovasc Intervent Radiol

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Purpose To evaluate the analgesic efficacy of oral premedication of oxycodone in a group of patients undergoing elective uterine artery embolization under sedation for fibroid disease. Methods Thirty-nine patients (mean age 42.3 years) were prospectively randomized 1:1 to receive 20 mg oxycodone or placebo orally immediately before their procedure. At the commencement of the procedure, patients were provided with a patient-controlled analgesia device for 24 h, programmed to deliver 1 mg boluses of intravenous morphine with a 5 min lockout. Mean visual analog scale pain intensity ratings (0-100 mm) were measured from both groups and evaluated over 0 to 6 h as the primary end point. Other measured parameters included opioid-related side effects and eligibility for discharge (NCT00163930; September 12, 2005). Results Early pain intensity did not vary significantly between the active and placebo groups [mean (standard deviation): 3.2 (2.5) vs. 3.1 (2.2), p = 0.89]. The oxycodone group, however, experienced significantly more nausea (p = 0.035) and a greater incidence of vomiting (p = 0.044). Overall opioid requirement over 24 h, measured as oral morphine equivalent, was greater in the oxycodone group (median [interquartile range]: 64.5

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Section: Introductionmentioning

confidence: 99%

A Randomized, Double-Blind, Placebo-Controlled Study of Preemptive Oral Oxycodone with Morphine Patient-Controlled Anesthesia for Postoperative Pain Management in Patients Undergoing Uterine Artery Embolization for Symptomatic Uterine Fibroids

Konstantatos

Kavnoudias

Stegeman

et al. 2014

Cardiovasc Intervent Radiol

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“…The first embolic agent available for UAE was non spherical polyvinyl alcohol (nPVA) particles (Contour; Target Vascular/Boston Scientific, Natick, MA,USA). Following that, several embolic agents have been used successfully for UAE, such as tris-acryl microspheres, gelatin sponge, and various types of microspheres (5)(6)(7)(8)(9)(10). Several recent studies have shown that the nature of the embolic agent does make a difference in the effect of UAE on tumors (11).…”

Section: Introductionmentioning

confidence: 99%

Non spherical polyvinyl alcohol versus gelatin sponge particles for uterine artery embolization for symptomatic fibroids

Song¹,

Jang²,

Park³

et al. 2013

Minimally Invasive Therapy & Allied Technologies

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“…After selective catheterization of the bilateral uterine arteries, uterine artery angiography was carried out to enable identification of the vasculature and parenchyma of the uterus. Embolization was performed in free flow: 0.1 mL of each embolic material (PVA particles and calibrated SPIO-embedded chitosan microspheres) was suspended in 4.9 mL of a mixture of iodinated contrast medium (Visipaque, GE Healthcare, Princeton, New Jersey, USA) and normal saline (1:1, v/v); this mixture was diluted to a concentration, 3.5 to 4.0 times lower than that used in clinical practice (11).…”

Section: Angiography and Embolization Protocolmentioning

confidence: 99%

MRI traceability of superparamagnetic iron oxide nanoparticle-embedded chitosan microspheres as an embolic material in rabbit uterus

Choi

Kwak

Shim

et al. 2015

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSEWe aimed to compare polyvinyl alcohol (PVA) particles with calibrated superparamagnetic iron oxide (SPIO) nanoparticle-loaded chitosan microspheres in a rabbit model, specifically regarding the relative distribution of embolic agents within the uterus based on magnetic resonance imaging (MRI) and pathological evaluation. METHODSTwelve New Zealand white rabbits underwent uterine artery embolization using either standard PVA particles (45-150 µm or 350-500 µm) or calibrated SPIO-embedded chitosan microspheres (45-150 µm or 300-500 µm). MRI and histopathological findings were compared one week after embolization. RESULTSCalibrated SPIO-loaded chitosan microspheres 45-150 µm in size were detected on T2-weighted images. On histological analysis, calibrated SPIO-embedded chitosan microspheres were found in both myometrium and endometrium, whereas PVA particles were found only in the perimyometrium or extrauterine fat pads. A proportional relationship was noted between the calibrated SPIO-embedded chitosan microsphere size and the size of the occluded artery. CONCLUSION Calibrated SPIO-embedded chitosan microspheres induced greater segmental arterial occlusion than PVA particles and showed great potential as a new embolic material. SPIO-embedded chitosan microspheres can be used to follow distribution of embolic particles through MRI studies.

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Comparison of Four Embolic Materials at Uterine Artery Embolization by Using Postprocedural MR Imaging Enhancement

Abstract: Patients treated with Bead Block or Contour SE demonstrated a reduced degree of infarction at follow-up MR imaging compared with patients treated with Contour or Embosphere.

Cited by 35 publications

References 12 publications

A Randomized, Double-Blind, Placebo-Controlled Study of Preemptive Oral Oxycodone with Morphine Patient-Controlled Anesthesia for Postoperative Pain Management in Patients Undergoing Uterine Artery Embolization for Symptomatic Uterine Fibroids

A Randomized, Double-Blind, Placebo-Controlled Study of Preemptive Oral Oxycodone with Morphine Patient-Controlled Anesthesia for Postoperative Pain Management in Patients Undergoing Uterine Artery Embolization for Symptomatic Uterine Fibroids

Non spherical polyvinyl alcohol versus gelatin sponge particles for uterine artery embolization for symptomatic fibroids

MRI traceability of superparamagnetic iron oxide nanoparticle-embedded chitosan microspheres as an embolic material in rabbit uterus

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