Clinical Long-Term Outcome and Reinterventional Rate After Uterine Fibroid Embolization with Nonspherical Versus Spherical Polyvinyl Alcohol Particles

Cardiovasc Intervent Radiol. 2016 Feb;39(2):204-9. doi: 10.1007/s00270-015-1157-5. Epub 2015 Jun 30.

Abstract

Purpose: This study was designed to evaluate the long-term clinical outcome and frequency of reinterventions in patients with uterine fibroids treated with embolization at a single center using polyvinyl alcohol microparticles.

Methods: The study included all patients with symptomatic uterine fibroids treated with uterine fibroid embolization (UFE) with spherical (s-PVA) and nonspherical (ns-PVA) polyvinyl alcohol microparticles during the period January 2001 to January 2011. Clinical success and secondary interventions were examined. Hospital records were reviewed during follow-up, and symptom-specific questionnaires were sent to all patients.

Results: In total, 515 patients were treated with UFE and 350 patients (67 %) were available for long-term clinical follow-up. Median time of follow-up was 93 (range 76-120.2) months. Eighty-five patients (72 %) had no reinterventions during follow-up in the group embolized with ns-PVA compared with 134 patients (58 %) treated with s-PVA. Thirty-three patients (28 %) underwent secondary interventions in the ns-PVA group compared with 98 patients (42 %) in s-PVA group (χ(2) test, p < 0.01).

Conclusions: Spherical PVA particles 500-700 µm showed high reintervention rate at long-term follow-up, and almost one quarter of the patients underwent secondary interventions, suggesting that this type of particle is inappropriate for UFE.

Keywords: Arterial intervention; Embolization; Embolotherapy; Uterine fibroid embolization (UFE).

MeSH terms

  • Adult
  • Embolization, Therapeutic / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Leiomyoma / therapy*
  • Middle Aged
  • Particle Size
  • Polyvinyl Alcohol / therapeutic use*
  • Retreatment
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Polyvinyl Alcohol