Uterine fibroid embolization with acrylamido polyvinyl microspheres: prospective 12-month clinical and MRI follow-up study

Background: Uterine fibroid embolization (UFE) is an effective minimally invasive treatment aimed to obtain complete fibroid infarction. Purpose: To evaluate the degree of fibroid infarction after embolization with acrylamido polyvinyl alcohol microspheres (Bead Block). Material and Methods: This prospective study included 26 pre-menopausal women in the period October 2013 to January 2015. UFE with the use of Bead Block microspheres 700-900 mu m was obtained until flow stasis was achieved. Contrast-enhanced magnetic resonance imaging (MRI) was used to define residual contrast enhancement in the total fibroid burden and enhancement >10% was defined as insufficient embolization. The dominant fibroid volume and total uterine volume changes were assessed. Clinical outcome was analyzed using the quality of life questionnaire (UFS-QOL). Results: Twenty-four of the 26 patients (92%) had a technically successful UFE with complete flow-stop in both uterine arteries. Twenty-two of the 26 patients (85%) completed 3 months of MRI control and 20 patients (77%) completed 12 months of MRI control. There were 16 of 22 patients (73%) with complete fibroid burden infarction and/or without residual contrast enhancement of the fibroids of more than 10% at 3 months of control. Six of 22 patients (27%) had insufficient fibroid burden infarction with residual contrast enhancement of more than 10%. Twenty-two and 18 of 26 patients completed the 3-month and 12-month questionnaire, respectively. UFS-QOL analyses showed that 91% of the patients had significant clinical improvement. Conclusion: Sixteen of the 22 patients had complete fibroid burden infarction using Bead Block microspheres (700-900 mu m); however, unacceptably high insufficient fibroid burden infarction in almost one-fourth of the patients were recorded.