Semin intervent Radiol 2022; 39(04): 416-420
DOI: 10.1055/s-0042-1758077
Review Article

Nononcologic Embolization

Cynthia De la Garza-Ramos
1   Division of Interventional Radiology, Mayo Clinic, Jacksonville, Florida
,
Aliaksei Salei
2   Division of Interventional Radiology, University of Alabama at Birmingham, Birmingham, Alabama
,
Theresa M. Caridi
2   Division of Interventional Radiology, University of Alabama at Birmingham, Birmingham, Alabama
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

The scope of conditions managed by embolization, which was initially used for the treatment of hemorrhage and vascular malformations, is constantly expanding. Apart from oncologic indications, embolization is used to treat a wide range of benign pathology, including uterine fibroids and benign prostatic hyperplasia. While various particulate embolic agents are successfully used for benign embolization, there is growing evidence that unique properties of these may result in different outcomes. This article reviews available evidence comparing various particles used for uterine fibroid embolization and prostate artery embolization. In addition, we provide an overview of periprocedural pharmacology and protocols facilitating same-day discharge for these interventions.

Keywords

embolization - uterine - prostate - benign - interventional radiology - postembolization syndrome - complication


Publication History

Article published online:
17 November 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 van der Kooij SM, Bipat S, Hehenkamp WJK, Ankum WM, Reekers JA. Uterine artery embolization versus surgery in the treatment of symptomatic fibroids: a systematic review and metaanalysis. Am J Obstet Gynecol 2011; 205 (04) 317.e1-317 .e18
    CrossrefPubMedGoogle Scholar
  • 2 Jun F, Yamin L, Xinli X. et al. Uterine artery embolization versus surgery for symptomatic uterine fibroids: a randomized controlled trial and a meta-analysis of the literature. Arch Gynecol Obstet 2012; 285 (05) 1407-1413
    CrossrefPubMedGoogle Scholar
  • 3 Binkert CA, Hirzel FC, Gutzeit A, Zollikofer CL, Hess T. Superior hypogastric nerve block to reduce pain after uterine artery embolization: advanced technique and comparison to epidural anesthesia. Cardiovasc Intervent Radiol 2015; 38 (05) 1157-1161
    CrossrefPubMedGoogle Scholar
  • 4 Noel-Lamy M, Tan KT, Simons ME, Sniderman KW, Mironov O, Rajan DK. Intraarterial lidocaine for pain control in uterine artery embolization: a prospective, randomized study. J Vasc Interv Radiol 2017; 28 (01) 16-22
    CrossrefPubMedGoogle Scholar
  • 5 Pelage J-P, Laurent A, Wassef M. et al. Uterine artery embolization in sheep: comparison of acute effects with polyvinyl alcohol particles and calibrated microspheres. Radiology 2002; 224 (02) 436-445
    CrossrefPubMedGoogle Scholar
  • 6 Rasuli P, Hammond I, Al-Mutairi B. et al. Spherical versus conventional polyvinyl alcohol particles for uterine artery embolization. J Vasc Interv Radiol 2008; 19 (01) 42-46
    CrossrefPubMedGoogle Scholar
  • 7 Spies JB, Allison S, Flick P. et al. Polyvinyl alcohol particles and tris-acryl gelatin microspheres for uterine artery embolization for leiomyomas: results of a randomized comparative study. J Vasc Interv Radiol 2004; 15 (08) 793-800
    CrossrefPubMedGoogle Scholar
  • 8 Han K, Kim SY, Kim HJ. et al. Nonspherical polyvinyl alcohol particles versus tris-acryl microspheres: randomized controlled trial comparing pain after uterine artery embolization for symptomatic fibroids. Radiology 2021; 298 (02) 458-465
    CrossrefPubMedGoogle Scholar
  • 9 Das R, Wale A, Renani SA. et al. Randomised controlled trial of particles used in uterine fibroid embolisation (PURE): non-spherical polyvinyl alcohol versus calibrated microspheres. Cardiovasc Intervent Radiol 2022; 45 (02) 207-215
    CrossrefPubMedGoogle Scholar
  • 10 Laurent A, Wassef M, Namur J, Ghegediban H, Pelage J-P. Arterial distribution of calibrated tris-acryl gelatin and polyvinyl alcohol embolization microspheres in sheep uterus. Cardiovasc Intervent Radiol 2010; 33 (05) 995-1000
    CrossrefPubMedGoogle Scholar
  • 11 Spies JB, Allison S, Flick P. et al. Spherical polyvinyl alcohol versus tris-acryl gelatin microspheres for uterine artery embolization for leiomyomas: results of a limited randomized comparative study. J Vasc Interv Radiol 2005; 16 (11) 1431-1437
    CrossrefPubMedGoogle Scholar
  • 12 Siskin GP, Beck A, Schuster M, Mandato K, Englander M, Herr A. Leiomyoma infarction after uterine artery embolization: a prospective randomized study comparing tris-acryl gelatin microspheres versus polyvinyl alcohol microspheres. J Vasc Interv Radiol 2008; 19 (01) 58-65
    CrossrefPubMedGoogle Scholar
  • 13 Yu SCH, Lok I, Ho SSY, Tong MMB, Hui JWY. Comparison of clinical outcomes of tris-acryl microspheres versus polyvinyl alcohol microspheres for uterine artery embolization for leiomyomas: results of a randomized trial. J Vasc Interv Radiol 2011; 22 (09) 1229-1235
    CrossrefPubMedGoogle Scholar
  • 14 Xiang P, Guan D, Du Z. et al. Efficacy and safety of prostatic artery embolization for benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials. Eur Radiol 2021; 31 (07) 4929-4946
    CrossrefPubMedGoogle Scholar
  • 15 Moreira AM, de Assis AM, Carnevale FC, Antunes AA, Srougi M, Cerri GG. A review of adverse events related to prostatic artery embolization for treatment of bladder outlet obstruction due to BPH. Cardiovasc Intervent Radiol 2017; 40 (10) 1490-1500
    CrossrefPubMedGoogle Scholar
  • 16 Bilhim T, Pisco J, Pereira JA. et al. Predictors of clinical outcome after prostate artery embolization with spherical and nonspherical polyvinyl alcohol particles in patients with benign prostatic hyperplasia. Radiology 2016; 281 (01) 289-300
    CrossrefPubMedGoogle Scholar
  • 17 Hwang JH, Park SW, Chang IS. et al. Comparison of nonspherical polyvinyl alcohol particles and microspheres for prostatic arterial embolization in patients with benign prostatic hyperplasia. BioMed Res Int 2017; 2017: 8732351
    CrossrefPubMedGoogle Scholar
  • 18 Wang MQ, Zhang JL, Xin HN. et al. Comparison of clinical outcomes of prostatic artery embolization with 50-μm plus 100-μm polyvinyl alcohol (PVA) particles versus 100-μm PVA particles alone: a prospective randomized trial. J Vasc Interv Radiol 2018; 29 (12) 1694-1702
    CrossrefPubMedGoogle Scholar
  • 19 Bilhim T, Pisco J, Campos Pinheiro L. et al. Does polyvinyl alcohol particle size change the outcome of prostatic arterial embolization for benign prostatic hyperplasia? Results from a single-center randomized prospective study. J Vasc Interv Radiol 2013; 24 (11) 1595-602 .e1
    CrossrefPubMedGoogle Scholar
  • 20 Amouyal G, Chague P, Pellerin O. et al. Safety and efficacy of occlusion of large extra-prostatic anastomoses during prostatic artery embolization for symptomatic BPH. Cardiovasc Intervent Radiol 2016; 39 (09) 1245-1255
    CrossrefPubMedGoogle Scholar
  • 21 Bhatia S, Sinha V, Bordegaray M, Kably I, Harward S, Narayanan G. Role of coil embolization during prostatic artery embolization: incidence, indications, and safety profile⋆ . J Vasc Interv Radiol 2017; 28 (05) 656-664 .e3
    CrossrefPubMedGoogle Scholar
  • 22 Isaacson AJ, Hartman TS, Bagla S, Burke CT. Initial experience with balloon-occlusion prostatic artery embolization. J Vasc Interv Radiol 2018; 29 (01) 85-89
    CrossrefPubMedGoogle Scholar
  • 23 Yu SCH, Cho C, Hung E. et al. Case-control study of intra-arterial verapamil for intraprostatic anastomoses to extraprostatic arteries in prostatic artery embolization for benign prostatic hypertrophy. J Vasc Interv Radiol 2017; 28 (08) 1167-1176
    CrossrefPubMedGoogle Scholar
  • 24 Gonçalves OM, Carnevale FC, Moreira AM, Antunes AA, Rodrigues VC, Srougi M. Comparative study using 100-300 versus 300-500 μm microspheres for symptomatic patients due to enlarged-BPH prostates. Cardiovasc Intervent Radiol 2016; 39 (10) 1372-1378
    CrossrefPubMedGoogle Scholar