Resorbable Gelatin Microspheres versus Tris-Acryl Microspheres: Randomized Controlled Trial Comparing Pain, Inflammatory Response and Embolic Effect after Uterine Artery Embolization for Symptomatic Fibroids

Monday, March 6, 2023

3:27 PM – 3:36 PM

Location: Phoenix Convention Center, 226ABC

Presenting Author(s)

KH

Kichang Han, MD, PhD

Assistant Professor
Severance Hospital, Yonsei University, College of Medicine

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

SK

So Yeon Kim, MD, PhD

Associate professor
Severance hospital
VL

Victor Liaw, Student

Medical student
UT southwestern
Man Deuk Kim, MD,PhD,FSIR

Chief of Vascular and Interventional Radiology
Severance Hospital, Yonsei University College of Medicine
JK

Joon Ho Kwon, MD

Clinical assistant professor
Severance hospital
SM

Sungmo Moon, MD

Professor
Severance hospital
Gyoung Min Kim, MD

Assistant Professor
Yonsei University Severance Hospital
Jong Yun Won, MD, PhD

Professor
Yonsei University College of Medicine, Severance H
JP

Juil Park, MD

Clinical Assistant Professor
Severance Hospital, Yonsei University, College of Medicine
HK

Hyung Cheol Kim, MD

Clinical assistant professor
Severance hospital

Disclosure(s):

Kichang Han, MD, PhD: No financial relationships to disclose

Man Deuk Kim, MD,PhD,FSIR: No financial relationships to disclose

Gyoung Min Kim, MD: No financial relationships to disclose

Purpose:

To compare pain and embolic effect after uterine artery embolization (UAE) with resorbable gelatin microspheres (RGM, Nexsphere) particles and tris-acryl gelatin microspheres (TAGM. embosphere).

Materials and Methods:

In this randomized controlled trial, participants were assigned to RGM or TAGM. Both groups were administered fentanyl-based intravenous patient-controlled analgesia during the first 24 hours after UAE and rescue analgesics. Neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), white blood cell (WBC) were measured to assess inflammatory response before and 24 hours after the procedure. Serum anti-Mullerian hormone (AMH) was also measured to assess the impact of UAE on ovarian function. Contrast-enhanced MRI 1 day and 3 months after UAE were used to evaluate the necrosis of the dominant fibroid and recanalization of the embolized uterine arteries. Symptom severity score (SSS) and health-related quality of life score (HRQOL) were assessed before and 3 months after UAE.

Results:

60 patients (mean age, 45.7 ± 3.6) were evaluated. Although pain scores were not different between the two groups, fentanyl consumption during 24 h was significantly lower in the RGM group. NLR, CRP, and WBC count were significantly higher in the RGM group at 24 hours (P < 0.001 for all the parameters). At 3 months, SSS and HRQOL were not significantly different between the two groups (P =0.81 for SSS, P=0.1 for HRQOL). Serum AMH levels were significantly decreased in both groups after the procedure (P< 0.001 for RGM, P=0.003 for TAGM). The rates of complete necrosis of the dominant fibroids were not significantly different (P=0.85). The rates of recanalization of the embolized uterine arteries were significantly higher in the RGM group (P=0.001)

Conclusion:

When used in UAE, RGM and TAGM were equally effective in obtaining complete necrosis of the dominant fibroids and improvement in symptoms. RGM induced a higher degree of inflammatory response and required less fentanyl consumption, but pain scores were similar between the two groups. Recanalization of the embolized uterine artery was more commonly observed in the RGM.