Document Detail


Spherical versus conventional polyvinyl alcohol particles for uterine artery embolization.
MedLine Citation:
PMID:  18192466     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To compare the efficacy of spherical polyvinyl alcohol (PVA) particles versus conventional PVA particles for uterine artery embolization (UAE). MATERIALS AND METHODS: Of 149 patients with 1-year follow-up after UAE, 96 received conventional PVA particles and 53 received spherical PVA particles. Severity of symptoms was ranked on an 11-point numeric rating scale (0-10). The changes in severity of symptoms after embolization, blood hemoglobin level, and the size of the dominant tumor depicted by ultrasonography were used to assess the efficacy of the two types of particles. The number of hysterectomies and myomectomies in each group was also recorded as evidence of UAE failure. RESULTS: On 1-year follow-up, patients treated with conventional PVA showed average numeric rating scale score improvements of 4.6 in menorrhagia, 2.9 in dysmenorrhea, 3.7 in pressure sensation, and 3.4 in urinary frequency. With spherical PVA, the average improvements were 3.0 in menorrhagia, 2.4 in dysmenorrhea, 3.1 in pressure sensation, and 2.0 in urinary frequency. Except in dysmenorrhea, all differences were significant (P < .001). With conventional PVA, there was an 8-mg/mL increase in blood hemoglobin level versus a 3-mg/mL increase with spherical PVA (P < .05). With conventional PVA, there was a 28-mm (34%) average reduction in diameter of the dominant tumor versus a 15.7-mm (19%) reduction with spherical PVA (P = .01). Eight of 96 patients (8%) treated with conventional PVA underwent hysterectomy or myomectomy during the entire length of the study, versus six of 53 patients (11%) treated with spherical PVA (P = .6). No patient underwent multiple embolizations. CONCLUSIONS: In comparison with conventional PVA particles, UAE with the use of spherical PVA particles resulted in less fibroid tumor shrinkage and less improvement in clinical symptoms.
Authors:
Pasteur Rasuli; Ian Hammond; Badr Al-Mutairi; Gordon J French; Jose Aquino; Adnan Hadziomerovic; Sally Goulet; Elaine E Jolly
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  19     ISSN:  1051-0443     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-14     Completed Date:  2008-03-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  42-6     Citation Subset:  IM    
Affiliation:
Department of Diagnostic Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada. prasuli@rogers.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Embolization, Therapeutic / adverse effects,  methods*
Female
Gynecologic Surgical Procedures
Humans
Hysterectomy
Infarction
Leiomyoma / blood supply,  pathology,  surgery,  therapy*
Microspheres*
Middle Aged
Particle Size
Polyvinyl Alcohol / therapeutic use*
Prospective Studies
Questionnaires
Severity of Illness Index
Time Factors
Treatment Failure
Treatment Outcome
Uterine Neoplasms / blood supply,  pathology,  surgery,  therapy*
Uterus / blood supply*,  pathology,  surgery
Chemical
Reg. No./Substance:
9002-89-5/Polyvinyl Alcohol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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