Skip to main content
Erschienen in: CardioVascular and Interventional Radiology 6/2004

01.11.2004 | Original Paper

FEMIC (Fibromes Embolisés aux MICrosphères calibrées): Uterine Fibroid Embolization using Tris-acryl Microspheres. A French Multicenter Study

verfasst von: Francis Joffre, Jean-Michel Tubiana, Jean-Pierre Pelage, Groupe FEMIC*

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 6/2004

Einloggen, um Zugang zu erhalten

Abstract

Purpose: A French multicenter registry was set up to confirm the safety and efficacy of large calibrated tris-acryl gelatin microspheres for embolization of symptomatic fibroids.
Methods: Technical recommendations included embolization using large microspheres (>500 µm) with no secondary embolization agent. Postprocedural pain, clinical improvement and adverse events were prospectively evaluated during a follow-up period of at least 6 months.
Results: Eighty-five women complaining of fibroid-related symptoms entered the study. In seven women, a secondary embolization agent was used in addition to microspheres. Complete resolution of menorrhagia was achieved in 84% of women at 24 months and significant uterine and fibroid volume reductions were noted after 6 months (37% and 73%, respectively). Three women experienced definitive amenorrhea (4%) and two women required hysteroscopic resection of a fibroid. Eight women were treated by hysterectomy because of treatment failure. In seven of these women, treatment failure was explained by an additional cause of symptoms including diffuse adenomyosis, endometrial hyperplasia or ovarian artery supply to the fibroids.
Conclusion: Limited uterine artery embolization using large microspheres has good clinical success rate with low postprocedural pain and complications. Women can expect excellent midterm results with a high level of symptom control and significant fibroid volume reduction. Confidence in the end-point recommended here may require the experience of several cases.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Vollenhoven, BJ, Lawrence, AS, Healy, DL 1990Uterine fibroids: A clinical reviewBr J Obstet Gynaecol97285298PubMed Vollenhoven, BJ, Lawrence, AS, Healy, DL 1990Uterine fibroids: A clinical reviewBr J Obstet Gynaecol97285298PubMed
2.
Zurück zum Zitat Benagiano, G, Morini, A, Primiero, FM 1992Fibroids: Overview of current and future treatment optionsBr J Obstet Gynaecol991822 Benagiano, G, Morini, A, Primiero, FM 1992Fibroids: Overview of current and future treatment optionsBr J Obstet Gynaecol991822
3.
Zurück zum Zitat Carlson, KJ, Nichols, DH, Schiff, I 1993Indications for hysterectomyN Engl J Med328856860CrossRefPubMed Carlson, KJ, Nichols, DH, Schiff, I 1993Indications for hysterectomyN Engl J Med328856860CrossRefPubMed
4.
Zurück zum Zitat Iverson, RE, Chelmow, D, Strohbehn, K, Waldman, L, Evantash, EG 1996Relative morbidity and mortality of abdominal hysterectomy and myomectomy for management of uterine leiomyomasObstet Gynecol88415419CrossRefPubMed Iverson, RE, Chelmow, D, Strohbehn, K, Waldman, L, Evantash, EG 1996Relative morbidity and mortality of abdominal hysterectomy and myomectomy for management of uterine leiomyomasObstet Gynecol88415419CrossRefPubMed
5.
Zurück zum Zitat Schofield, MJ, Bennet, A, Redman, S, Walters, WA, Sanson-Fisher, RW 1991Self-reported long-term outcomes of hysterectomyBr J Obstet Gynaecol9811291136PubMed Schofield, MJ, Bennet, A, Redman, S, Walters, WA, Sanson-Fisher, RW 1991Self-reported long-term outcomes of hysterectomyBr J Obstet Gynaecol9811291136PubMed
6.
Zurück zum Zitat Hutchins, FL Jr, Worthington-Kirsch, R, Berkowitz, RP 1999Selective uterine artery embolization as primary treatment for symptomatic leiomyomata uteriJ Am Assoc Gynecol Laparosc6279284PubMed Hutchins, FL Jr, Worthington-Kirsch, R, Berkowitz, RP 1999Selective uterine artery embolization as primary treatment for symptomatic leiomyomata uteriJ Am Assoc Gynecol Laparosc6279284PubMed
7.
Zurück zum Zitat Spies, JB, Ascher, SM, Roth, AR, Kim, J, Levy, EB, Gomez-Jorge, J 2001Uterine artery embolization for leiomyomataObstet Gynecol982934CrossRefPubMed Spies, JB, Ascher, SM, Roth, AR, Kim, J, Levy, EB, Gomez-Jorge, J 2001Uterine artery embolization for leiomyomataObstet Gynecol982934CrossRefPubMed
8.
Zurück zum Zitat Walker, WJ, Pelage, JP 2002Uterine artery embolisation for symptomatic fibroids: Clinical results in 400 women with imaging follow upBr J Obstet Gynaecol10912621272 Walker, WJ, Pelage, JP 2002Uterine artery embolisation for symptomatic fibroids: Clinical results in 400 women with imaging follow upBr J Obstet Gynaecol10912621272
9.
Zurück zum Zitat Pelage, JP, Le Dref, O, Soyer, P, et al. 2000Fibroid-related menorrhagia: Treatment with superselective embolization of the uterine arteries and midterm follow-upRadiology215428431PubMed Pelage, JP, Le Dref, O, Soyer, P,  et al. 2000Fibroid-related menorrhagia: Treatment with superselective embolization of the uterine arteries and midterm follow-upRadiology215428431PubMed
10.
Zurück zum Zitat Laurent, A, Beaujeux, R, Wassef, M, Rüfenacht, D, Boschetti, E, Merland, J 1996Trisacryl gelatin microspheres for therapeutic embolization. I. Development and in vitro evaluationAJNR Am J Neuroradiol17533540 Laurent, A, Beaujeux, R, Wassef, M, Rüfenacht, D, Boschetti, E, Merland, J 1996Trisacryl gelatin microspheres for therapeutic embolization. I. Development and in vitro evaluationAJNR Am J Neuroradiol17533540
11.
Zurück zum Zitat Beaujeux, R, Laurent, A, Wassef, M, et al. 1996Trisacryl gelatin microspheres for therapeutic embolization. II. Preliminary clinical evaluation in tumors and arteriovenous malformationsAJNR Am J Neuroradiol17541548 Beaujeux, R, Laurent, A, Wassef, M,  et al. 1996Trisacryl gelatin microspheres for therapeutic embolization. II. Preliminary clinical evaluation in tumors and arteriovenous malformationsAJNR Am J Neuroradiol17541548
12.
Zurück zum Zitat Bendzus, M, Klein, R, Burger, R, Warmuth-Metz, M, Hofmann, E, Solymosi, L 2000Efficacy of trisacryl gelatin microspheres versus polyvinyl alcohol particles in the preoperative embolization of meningiomasAJNR Am J Neuroradiol21255261 Bendzus, M, Klein, R, Burger, R, Warmuth-Metz, M, Hofmann, E, Solymosi, L 2000Efficacy of trisacryl gelatin microspheres versus polyvinyl alcohol particles in the preoperative embolization of meningiomasAJNR Am J Neuroradiol21255261
13.
Zurück zum Zitat Derdeyn, C, Graves, V, Salamat, M, Rappe, A 1997Collagen-coated acrylic microspheres for embolotherapy: in vivo and in vitro characteristicsAJNR Am J Neuroradiol18647653 Derdeyn, C, Graves, V, Salamat, M, Rappe, A 1997Collagen-coated acrylic microspheres for embolotherapy: in vivo and in vitro characteristicsAJNR Am J Neuroradiol18647653
14.
Zurück zum Zitat Pelage, JP, Laurent, A, Wassef, M, et al. 2002Uterine artery embolization in the sheep: Comparison between polyvinyl alcohol particles and calibrated microspheresRadiology224436445PubMed Pelage, JP, Laurent, A, Wassef, M,  et al. 2002Uterine artery embolization in the sheep: Comparison between polyvinyl alcohol particles and calibrated microspheresRadiology224436445PubMed
15.
Zurück zum Zitat Pelage, JP, Le Dref, O, Beregi, JP, Nonent, M, Robert, Y, Cosson, M, Jacob, D, Truc, JB, Laurent, A, Rymer, R 2003Limited uterine artery embolization with tris-acryl microspheres for uterine fibroidsJ Vasc Interv Radiol141520 Pelage, JP, Le Dref, O, Beregi, JP, Nonent, M, Robert, Y, Cosson, M, Jacob, D, Truc, JB, Laurent, A, Rymer, R 2003Limited uterine artery embolization with tris-acryl microspheres for uterine fibroidsJ Vasc Interv Radiol141520
16.
Zurück zum Zitat Spies, JB, Benenati, JE, Worthington-Kirsch, RL, Pelage, JP 2001Initial experience with trisacryl gelatin microspheres for uterine artery embolization for leiomyomataJ Vasc Interv Radiol1210591063PubMed Spies, JB, Benenati, JE, Worthington-Kirsch, RL, Pelage, JP 2001Initial experience with trisacryl gelatin microspheres for uterine artery embolization for leiomyomataJ Vasc Interv Radiol1210591063PubMed
17.
Zurück zum Zitat McLucas, B, Adler, L, Perella, R 2001Uterine fibroid embolization: Nonsurgical treatment for symptomatic fibroidsJ Am Coll Surg19295105CrossRefPubMed McLucas, B, Adler, L, Perella, R 2001Uterine fibroid embolization: Nonsurgical treatment for symptomatic fibroidsJ Am Coll Surg19295105CrossRefPubMed
18.
Zurück zum Zitat Derdeyn, C, Moran, C, Cross, D, Dietrich, H, Dacey, R 1995Polyvinyl alcohol particle size and suspension characteristicsAJNR Am J Neuroradiol1613351343 Derdeyn, C, Moran, C, Cross, D, Dietrich, H, Dacey, R 1995Polyvinyl alcohol particle size and suspension characteristicsAJNR Am J Neuroradiol1613351343
19.
Zurück zum Zitat Siskin, GP, Tublin, ME, Stainken, BF, Dowling, K, Dolen, EG 2001Uterine artery embolization for the treatment of adenomyosis: Clinical response and evaluation with MR imagingAJR Am J Roentgenol177297302PubMed Siskin, GP, Tublin, ME, Stainken, BF, Dowling, K, Dolen, EG 2001Uterine artery embolization for the treatment of adenomyosis: Clinical response and evaluation with MR imagingAJR Am J Roentgenol177297302PubMed
20.
Zurück zum Zitat Spies, JB, Spector, A, Roth, AR, Baker, CM, Mauro, L, Murphy-Skrynarz, K 2002Complications after uterine artery embolization for leiomyomasObstet Gynecol100873880CrossRefPubMed Spies, JB, Spector, A, Roth, AR, Baker, CM, Mauro, L, Murphy-Skrynarz, K 2002Complications after uterine artery embolization for leiomyomasObstet Gynecol100873880CrossRefPubMed
21.
Zurück zum Zitat Yeagley, TJ, Goldberg, J, Klein, TA, Bonn, J 2002Labial necrosis after uterine artery embolization for leiomyomataObstet Gynecol100881882CrossRefPubMed Yeagley, TJ, Goldberg, J, Klein, TA, Bonn, J 2002Labial necrosis after uterine artery embolization for leiomyomataObstet Gynecol100881882CrossRefPubMed
22.
Zurück zum Zitat Amato, P, Roberts, AC 2001Transient ovarian failure: A complication of uterine artery embolizationFertil Steril75438439CrossRefPubMed Amato, P, Roberts, AC 2001Transient ovarian failure: A complication of uterine artery embolizationFertil Steril75438439CrossRefPubMed
23.
Zurück zum Zitat Godfrey, CD, Zbella, EA 2001Uterine necrosis after uterine artery embolization for leiomyomaObstet Gynecol98950952CrossRefPubMed Godfrey, CD, Zbella, EA 2001Uterine necrosis after uterine artery embolization for leiomyomaObstet Gynecol98950952CrossRefPubMed
24.
Zurück zum Zitat Stringer, NH, Grant, T, Park, J, Oldham, L 2000Ovarian failure after uterine artery embolization for treatment of myomasJ Am Assoc Gynecol Laparosc7395400PubMed Stringer, NH, Grant, T, Park, J, Oldham, L 2000Ovarian failure after uterine artery embolization for treatment of myomasJ Am Assoc Gynecol Laparosc7395400PubMed
25.
Zurück zum Zitat Vashisht, A, Studd, JWW, Carey, AH, et al. 2000Fibroid embolisation: A technique not without significant complicationsBr J Obstet Gynaecol10711661170 Vashisht, A, Studd, JWW, Carey, AH,  et al. 2000Fibroid embolisation: A technique not without significant complicationsBr J Obstet Gynaecol10711661170
26.
Zurück zum Zitat Goodwin, S, McLucas, B, Lee, M, et al. 1999Uterine artery embolization for the treatment of uterine leiomyomata: Midterm resultsJ Vasc Interv Radiol1011591165PubMed Goodwin, S, McLucas, B, Lee, M,  et al. 1999Uterine artery embolization for the treatment of uterine leiomyomata: Midterm resultsJ Vasc Interv Radiol1011591165PubMed
27.
Zurück zum Zitat Goodwin, S, Vedantham, S, McLucas, B, Forno, A, Perrella, R 1997Preliminary experience with uterine artery embolization for uterine fibroidsJ Vasc Interv Radiol8517526PubMed Goodwin, S, Vedantham, S, McLucas, B, Forno, A, Perrella, R 1997Preliminary experience with uterine artery embolization for uterine fibroidsJ Vasc Interv Radiol8517526PubMed
28.
Zurück zum Zitat Goodwin, SC, Walker, WJ 1998Uterine artery embolization for the treatment of uterine fibroidsCurr Opin Obstet Gynecol10315320CrossRefPubMed Goodwin, SC, Walker, WJ 1998Uterine artery embolization for the treatment of uterine fibroidsCurr Opin Obstet Gynecol10315320CrossRefPubMed
29.
Zurück zum Zitat Ravina, J, Herbreteau, D, Ciraru-Vigneron, N, et al. 1995Arterial embolisation to treat uterine myomataLancet346671672CrossRefPubMed Ravina, J, Herbreteau, D, Ciraru-Vigneron, N,  et al. 1995Arterial embolisation to treat uterine myomataLancet346671672CrossRefPubMed
30.
Zurück zum Zitat Spies, J, Scialli, A, Jha, R, et al. 1999Initial results from uterine fibroid embolization for symptomatic leiomyomataJ Vasc Interv Radiol1011491157PubMed Spies, J, Scialli, A, Jha, R,  et al. 1999Initial results from uterine fibroid embolization for symptomatic leiomyomataJ Vasc Interv Radiol1011491157PubMed
31.
Zurück zum Zitat Bradley, EA, Reidy, JF, Forman, RG, Jarosz, J, Braude, PR 1998Transcatheter uterine embolisation to treat large uterine fibroidsBr J Obstet Gynaecol105235240PubMed Bradley, EA, Reidy, JF, Forman, RG, Jarosz, J, Braude, PR 1998Transcatheter uterine embolisation to treat large uterine fibroidsBr J Obstet Gynaecol105235240PubMed
32.
Zurück zum Zitat Worthington-Kirsch, RL, Popky, GL, Hutchins, FL 1998Uterine arterial embolization for the management of leiomyomas: Quality-of-life assessment and clinical responseRadiology208625629PubMed Worthington-Kirsch, RL, Popky, GL, Hutchins, FL 1998Uterine arterial embolization for the management of leiomyomas: Quality-of-life assessment and clinical responseRadiology208625629PubMed
33.
Zurück zum Zitat Andersen, PE, Lund, N, Justesen, P, Munk, T, Elle, B, Floridon, C 2001Uterine artery embolization of symptomatic uterine fibroids: Initial success and short-term resultsActa Radiol42234238CrossRefPubMed Andersen, PE, Lund, N, Justesen, P, Munk, T, Elle, B, Floridon, C 2001Uterine artery embolization of symptomatic uterine fibroids: Initial success and short-term resultsActa Radiol42234238CrossRefPubMed
34.
Zurück zum Zitat Ryu, RK, Chrisman, HB, Omary, RA, et al. 2001The vascular impact of uterine artery embolization: Prospective sonographic assessment of ovarian arterial circulationJ Vasc Interv Radiol1211711174 Ryu, RK, Chrisman, HB, Omary, RA,  et al. 2001The vascular impact of uterine artery embolization: Prospective sonographic assessment of ovarian arterial circulationJ Vasc Interv Radiol1211711174
35.
Zurück zum Zitat Chrisman, HB, Saker, MB, Ryu, RK, et al. 2000The impact of uterine fibroid embolization on resumption of menses and ovarian functionJ Vasc Interv Radiol11699703PubMed Chrisman, HB, Saker, MB, Ryu, RK,  et al. 2000The impact of uterine fibroid embolization on resumption of menses and ovarian functionJ Vasc Interv Radiol11699703PubMed
36.
Zurück zum Zitat Pelage, JP, Walker, WJ, Le Dref, O, Rymer, R 2003Ovarian artery: Angiographic appearance, embolization and relevance to uterine fibroid embolizationCardiovasc Intervent Radiol26227233 Pelage, JP, Walker, WJ, Le Dref, O, Rymer, R 2003Ovarian artery: Angiographic appearance, embolization and relevance to uterine fibroid embolizationCardiovasc Intervent Radiol26227233
37.
Zurück zum Zitat Smith, SJ, Sewall, LE, Handelsman, A 1999A clinical failure of uterine fibroid embolization due to adenomyosisJ Vasc Interv Radiol1011711174PubMed Smith, SJ, Sewall, LE, Handelsman, A 1999A clinical failure of uterine fibroid embolization due to adenomyosisJ Vasc Interv Radiol1011711174PubMed
38.
Zurück zum Zitat Bazot, M, Darai, E, Rouger, J, Detchev, R, Cortez, A, Uzan, S 2002Limitations of transvaginal sonography for the diagnosis of adenomyosis, with histopathological correlationUltrasound Obstet Gynecol20605611CrossRefPubMed Bazot, M, Darai, E, Rouger, J, Detchev, R, Cortez, A, Uzan, S 2002Limitations of transvaginal sonography for the diagnosis of adenomyosis, with histopathological correlationUltrasound Obstet Gynecol20605611CrossRefPubMed
39.
Zurück zum Zitat Byun, JY, Kim, SE, Choi, BG, Ko, GY, Jung, SE, Choi, KH 1999Diffuse and focal adenomyosis: MR imaging findingsRadiographics19S161S170PubMed Byun, JY, Kim, SE, Choi, BG, Ko, GY, Jung, SE, Choi, KH 1999Diffuse and focal adenomyosis: MR imaging findingsRadiographics19S161S170PubMed
40.
Zurück zum Zitat Spies, JB 2003Uterine artery embolization for fibroids: Understanding the technical causes of failureJ Vasc Interv Radiol141114 Spies, JB 2003Uterine artery embolization for fibroids: Understanding the technical causes of failureJ Vasc Interv Radiol141114
Metadaten
Titel
FEMIC (Fibromes Embolisés aux MICrosphères calibrées): Uterine Fibroid Embolization using Tris-acryl Microspheres. A French Multicenter Study
verfasst von
Francis Joffre
Jean-Michel Tubiana
Jean-Pierre Pelage
Groupe FEMIC*
Publikationsdatum
01.11.2004
Verlag
Springer-Verlag
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 6/2004
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-004-0078-5

Weitere Artikel der Ausgabe 6/2004

CardioVascular and Interventional Radiology 6/2004 Zur Ausgabe

PET kann infarktgefährdete Koronararterien entdecken

04.06.2024 Koronare Herzerkrankung Nachrichten

Der Nachweis aktiver Plaques mittels 18F-Natriumfluorid-PET hilft nicht nur, infarktgefährdete Patienten, sondern auch infarktgefährdete Koronararterien zu erkennen. Von einer gezielten Behandlung vulnerabler Plaques ist man trotzdem weit entfernt.

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

26.05.2024 Mammakarzinom Nachrichten

Frauen, die zum Zeitpunkt der Brustkrebsdiagnose eine hohe mammografische Brustdichte aufweisen, haben ein erhöhtes Risiko für ein baldiges Rezidiv, legen neue Daten nahe.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.