Efficacy of Acrylamido Polyvinyl Alcohol Hydrogel Microspheres for Uterine Artery Embolisation for Leiomyoma
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.
中文摘要
丙烯胺聚乙烯醇凝膠微球用於子宮肌瘤的動脈栓塞術的效果
黃慧美、朱兆麒、曹偉權
目的：探討在香港一所中心內，丙烯酰胺聚乙烯醇凝膠微球（A-PVAM）用於子宮肌瘤動脈栓塞術的效果。
方法：本研究回顧在2009年至2012年期間一個本地中心內使用A-PVAM作子宮肌瘤動脈栓塞術的病例。由未參與手術的獨立放射科醫生分別評估病人在栓塞術前後的磁共振圖像，計算子宮和主要子宮肌瘤的體積減少比例。並翻查手術程序的細節、血管造影特徵和臨床診斷的資料。與手術相關的併發症和臨床結果也一一進行了研究。
結果：共5例被納入本研究。所有患者的子宮和主要子宮肌瘤體積均有減少。主要子宮肌瘤的體積平均縮小了45.8%（介乎18.2%至78.8%）；子宮的體積也平均縮小了31.4%（介乎12.8%至53.5%）。所有患者栓塞術後的掃描均顯示肌瘤壞死。無手術相關併發症的發生，如子宮內膜炎、盆腔炎、子宮平滑肌瘤經宮頸剝脫、子宮缺血或卵巢功能喪失。5例患者在壓力和／或月經過多的症狀方面均有改善。
結論：雖然本研究的病例數目有限，但也證明A-PVAM用以子宮肌瘤動脈栓塞術治療效果積極的機率高。未來對於包括A-PVAM在內的子宮動脈栓塞術新型栓塞劑的進一步研究會很有用。