Efficacy of Acrylamido Polyvinyl Alcohol Hydrogel Microspheres for Uterine Artery Embolisation for Leiomyoma

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WM Wong, FSK Chu, WK Tso

Hong Kong J Radiol 2014;17:228-33

DOI: 10.12809/hkjr1414229

Objective: To evaluate the efficacy of acrylamido polyvinyl alcohol hydrogel microspheres (A-PVAM) for uterine artery embolisation for leiomyoma in our centre in Hong Kong.

Methods: This retrospective study reviewed cases that underwent uterine artery embolisation for symptomatic leiomyomas using A-PVAM from 2009 to 2012 in a single local institute. Pre- and post-embolisation magnetic resonance images of pelvis were evaluated by independent radiologists who were not involved in the procedures, and reduction in the volumes of uterus and dominant leiomyoma was calculated. Procedural details, angiographic features, and clinical consultation notes were reviewed. Procedure-related complications and clinical outcomes were studied.

Results: A total of five patients were included in the study. All patients showed reduction in the volumes of the uterus and dominant leiomyomas. The mean volume reduction in the dominant leiomyoma was 45.8% (range, 18.2%-78.8%), and mean uterine volume reduction was 31.4% (range, 12.8%-53.5%). Post-embolisation scans of all patients showed necrosis of the leiomyomas. No procedure-related complications such as endometritis, pelvic inflammatory disease, transcervical expulsion of leiomyomas, uterine ischaemia, or loss of ovarian function were noted. All the five patients had clinical improvement in their pressure and / or menorrhagia symptoms.

Conclusion: A-PVAM for uterine artery embolisation for leiomyomas in the manner described resulted in high rates of positive outcomes in our limited sample size. Further research on new embolic agents for uterine artery embolisation including A-PVAM would be useful.