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

Song, Yoon‐Jae; Jang, Hong; Park, Keung Do; Kim, Man Deuk; Kim, Chang Woon

doi:10.3109/13645706.2013.826674

Cited by 20 publications

(21 citation statements)

References 40 publications

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“…While several studies have compared various embolic agents for UAE, 20 – 24 to our knowledge, only one recent study compared gelatin sponge particles with another embolic agent. 25 In their report, gelatin sponge particles were not shown to be inferior to nPVA particles in terms of improvement of mean bleeding score and rate of volume reduction of the dominant fibroid (60.2%±18.1%) at the 3-month follow-up after UAE, 25 while only 33.4% of the size reduction in the dominant fibroid was seen in our study. However, this study was conducted at a single institution with a relatively small number of patients and short follow-up period.…”

Section: Discussioncontrasting

confidence: 55%

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

Toda¹,

Sawada²,

Osuga³

et al. 2016

IJWH

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AimThe aim of this study was to retrospectively analyze the efficacies of uterine artery embolization (UAE) using gelatin sponge for symptomatic uterine fibroids.MethodsA series of 60 consecutive premenopausal women underwent UAE using gelatin sponge particles or porous gelatin particles. Patients were routinely followed up at 1, 3, 6, and 12 months after the procedure and asked to report any procedure-related complications. At each follow-up, an original clinical questionnaire was completed by the patients to evaluate changes in fibroid-related symptoms. Pelvic magnetic resonance imaging was performed before and at 3 and 12 months after the procedure, and the changes in volume of the dominant fibroid were calculated.ResultsBilateral UAE was successfully performed in all the patients. Median age was 45 years (range 34–53 years), and median follow-up period was 25.2 months (range 1–116 months). At the 3- and 12-month follow-up, the dominant fibroid volumes were found to be significantly decreased by 33.4% (95% confidence interval [CI]: 24.9–41.1) and 48.4% (95% CI: 40.7–56.1) compared to baseline volumes, respectively. Excluding patients not having menorrhagia or bulk-related symptoms, at 12 months 49 of 50 (98%) women showed improvement in menorrhagia, and 45 of 47 (95.7%) women showed improvement in bulk-related symptoms. During the follow-up period, ten patients (16.7%) required further interventions including two patients who had undergone hysterectomy. No sequelae were experienced by any of the patients.ConclusionUAE using gelatin sponge was associated with a high clinical success rate and good fibroid volume reduction compared to UAE using other embolic agents.

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Section: Discussioncontrasting

confidence: 55%

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

Toda¹,

Sawada²,

Osuga³

et al. 2016

IJWH

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“…Kim et al [21] compared patients who had utero-ovarian anastomoses with those who did not have anastomoses, as demonstrated at angiography. Song et al [22] compared two embolization particles with one group having nonspherical polyvinyl alcohol particles and the other having gelatin sponge particles. Ikink et al [23] compared MRgFUS to UAE.…”

Section: Uterine Artery Embolizationmentioning

confidence: 99%

Nonresective treatments for uterine fibroids: a systematic review of uterine and fibroid volume reductions

Taheri

Galo

Potts

et al. 2019

International Journal of Hyperthermia

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Patients are increasingly seeking uterus-preserving, minimally invasive treatments for symptomatic uterine fibroids. This has led to a greater use of nonresective treatments such as uterine artery embolization (UAE), focused ultrasound (FUS) and more recently, radiofrequency ablation (RFA) of fibroids. This systematic review, following PRISMA guidelines, examines the change in uterine and fibroid volumes associated with UAE, FUS, and RFA. Pubmed and MedlinePlus databases were searched from 1956 to 2016. The keywords used were 'radiofrequency ablation,' 'magnetic resonance guided focused ultrasound,' 'ultrasound guided focused ultrasound', 'uterine artery embolization,' 'uterine fibroid embolization,' and 'leiomyoma' or 'fibroid'. Publications with at least 20 patients were included. Data were collected and analyzed using Microsoft Excel V R (Microsoft Corporation, Redmond, WA) software. Eighty-one relevant papers were identified: 52 related to UAE, 11 to RFA, 17 to FUS, 1 compared UAE and FUS. We report the published uterine volume and fibroid volume changes seen in these studies at 1 to 36 months. The pooled fibroid volume reductions at six months seen with RFA were 70%, UAE 54% and FUS 32%. All three types of nonresective treatment result in fibroid volume reduction. However, fibroid volume reduction is most marked with RFA, with UAE resulting in the next most volume reduction. Additional larger cohort studies, including those that are randomized and/or comparative, would enable definitive conclusions. This is the first systematic review comparing uterine and fibroid volume reduction after RFA, UAE and MRgFUS. ARTICLE HISTORY

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“…Spherical polyvinyl alcohol particles have shown comparatively unacceptable rates of failure in three randomized controlled trials (59,65,66). Gelatin sponge embolization has been successfully used, although considered less precise, and has recently been studied in Korea with superior results compared with embolization using polyvinyl alcohol (61). Polyzene F-coated hydrogel microspheres (67,68) and a pingyangmycin lipiodol emulsion and silk-segment embolic (69) have shown good results.…”

Section: State Of the Art: Management Of Uterine Fibroidsmentioning

confidence: 99%

“…Most UAE procedures are performed with intravenous sedation (29) by means of a right common femoral approach with a reverse curved 4-or 5-F catheter to access the contralateral internal iliac artery followed by formation of a Waltman loop to access the ipsilateral internal iliac artery (48,59-61) ( Fig 5). Some investigators suggest the routine use of a microcatheter, for example, a 2.7-F Progreat (Terumo, Somerset, NJ) to preserve flow in the uterine artery and facilitate access to distal branches (48,59,(61)(62)(63)(64).…”

Section: Technical Details and Costmentioning

confidence: 99%

Management of Uterine Fibroids: A Focus on Uterine-sparing Interventional Techniques

Silberzweig¹,

Powell²,

Matsumoto³

et al. 2016

Radiology

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Uterine fibroids occur in approximately 50% of women over the age of 40 years, and an estimated 50% of those are symptomatic. Menorrhagia is the most common symptom and the primary indication for treatment, although bulk symptoms often occur and can be treated. Pharmacotherapy is typically inadequate unless it can be expected to successfully bridge to menopause or allow for a less-invasive intervention. However, hormonal therapies have risks. Hysterectomy is still the most commonly performed procedure for symptomatic fibroids and has the lowest rate of reintervention (compared with myomectomy or uterine artery embolization [UAE]), but rates of more serious complications are higher and patient satisfaction and ability to return to normal activities may also be less favorable. Myomectomy is not necessarily less morbid than hysterectomy and may have a greater failure rate than UAE. Techniques and devices vary with little standardization, and operator experience is crucial to success. The largest studies of UAE show very low rates of serious complications and rapid recovery. UAE significantly improves symptoms related to uterine fibroids in 85%-90% of patients. Herein, this article will discuss the nature of fibroids and their diagnosis, pharmacotherapy, surgical treatment, and nonsurgical interventional treatment, including UAE and magnetic resonance-guided focused ultrasound. (©) RSNA, 2016.

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

Cited by 20 publications

References 40 publications

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

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

Nonresective treatments for uterine fibroids: a systematic review of uterine and fibroid volume reductions

Management of Uterine Fibroids: A Focus on Uterine-sparing Interventional Techniques

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