Leiomyoma treatment by uterine artery embolization using gelatin sponge prepared by the pumping method

Abstract

Uterine leiomyoma, a benign tumor, may be treated with drugs, albeit surgical resection is more common. The present study aimed to evaluate the treatment of leiomyoma cases by uterine artery embolization (UAE) using a gelatin sponge prepared by the pumping method. The results of 700 leiomyoma cases treated by UAE in the outpatient department were evaluated. UAE was performed by injecting gelatin sponge prepared by the pumping method into the uterine artery. Among 700 cases, effective cases were 680 (97.2%), ineffective cases were 18 (2.8%) and impossible cases for UAE were 2 (0.2%). Retreatment was required in 23 cases (3.3%). Complication events designated by the Society of Interventional Radiology Clinical Practice Guidelines occurred in 31 cases (4.4%): 1 case showed permanent adverse sequelae, 4 cases required major therapy with a prolonged hospitalization (>48 h) and 10 patients required therapy with minor hospitalization (<48 h). The remaining 16 cases required nominal or no therapy. Follow-up of patients was performed for 599 cases for an average period of 1.2±0.9 years, ranging between 1 month and 6 years. Pregnancy after UAE was observed in 12 cases/15 cycles. Thus, the findings indicate that UAE using gelatin sponge prepared by the pumping method applied to outpatients is a safe and useful treatment procedure.

Uterine necrosis following uterine artery embolism due to postpartum hemorrhage: A case report and review

“…Transabdominal color Doppler ultrasonography ( Figure 1A) and dynamic computed tomography confirmed two extravasations into the uterine cavity originating from the right and left uterine arteries, respectively ( Figure 1B). We then performed UAE into the bilateral uterine arteries using an absorbable gelatin sponge (Serescue, Nippon Kayaku Co., Ltd., Tokyo, Japan) prepared by the pumping method, 5,6) and the extravasation disappeared. We began transfusion before performing UAE, and a total of 4 units of red cell concentrate and 4 units of fresh frozen plasma were transfused until just before the UAE.…”

Unique Learning System for Uterine Artery Embolization for Symptomatic Myoma and Adenomyosis for Obstetrician-Gynecologists in Cooperation with Interventional Radiologists: Evaluation of UAE From the Point of View of Gynecologists Who Perform UAE

“…Embolization is performed using a gelatin sponge (Spongel; Astellas, Tokyo, Japan), and the embolic agent is created using the pumping or cutting method. In the pumping method [13], the water-soaked gelatin sponge is compressed into a syringe from which air is evacuated, and another syringe containing the contrast agent is connected via a T-shaped stopcock to the gelatin-containing syringe; subsequently, the gelatin sponge is crushed by alternately pumping 2 two syringes approximately 5 times. In the cutting method, the gelatin sponge, which is provided in the form of a sheet, is cut into approximately 1-mm cubes with a scalpel and scissors [14,15].…”

Efficacies of uterine artery embolization for symptomatic uterine fibroids using gelatin sponge: a single-center experience and literature review

“… 7 However, in Japan, these embolic agents were not commercially available until 2014, and gelatin sponge particles cut from sheets or porous gelatin particle (PGP), a roughly calibrated embolic agent made of gelatin sponge, have been used for UAE. 8 While several articles have shown that the outcomes of UAE using gelatin sponge were comparable to those of UAE using other embolic agents, 8 – 10 these reports were single-institutional studies, and further accumulation of clinical evidence is warranted. With this in mind, we retrospectively analyzed our 10-year experience of UAE with gelatin sponge particles and PGP and assessed the long-term clinical outcomes alongside a literature review.…”