Skip to main content
SpringerLink
Log in

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

  • Original Paper
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.
Fig. 2.

Similar content being viewed by others

References

  1. BJ Vollenhoven AS Lawrence DL Healy (1990) ArticleTitleUterine fibroids: A clinical review Br J Obstet Gynaecol 97 285–298 Occurrence Handle1:STN:280:By%2BB2Mvgs1I%3D Occurrence Handle2187522

    CAS  PubMed  Google Scholar 

  2. G Benagiano A Morini FM Primiero (1992) ArticleTitleFibroids: Overview of current and future treatment options Br J Obstet Gynaecol 99 18–22

    Google Scholar 

  3. KJ Carlson DH Nichols I Schiff (1993) ArticleTitleIndications for hysterectomy N Engl J Med 328 856–860 Occurrence Handle10.1056/NEJM199303253281207 Occurrence Handle1:STN:280:ByyC1c%2Fos1M%3D Occurrence Handle8357364

    Article  CAS  PubMed  Google Scholar 

  4. RE Iverson D Chelmow K Strohbehn L Waldman EG Evantash (1996) ArticleTitleRelative morbidity and mortality of abdominal hysterectomy and myomectomy for management of uterine leiomyomas Obstet Gynecol 88 415–419 Occurrence Handle10.1016/0029-7844(96)00218-9 Occurrence Handle8752251

    Article  PubMed  Google Scholar 

  5. MJ Schofield A Bennet S Redman WA Walters RW Sanson-Fisher (1991) ArticleTitleSelf-reported long-term outcomes of hysterectomy Br J Obstet Gynaecol 98 1129–1136 Occurrence Handle1:STN:280:By2C3czgtFM%3D Occurrence Handle1760425

    CAS  PubMed  Google Scholar 

  6. FL Jr Hutchins R Worthington-Kirsch RP Berkowitz (1999) ArticleTitleSelective uterine artery embolization as primary treatment for symptomatic leiomyomata uteri J Am Assoc Gynecol Laparosc 6 279–284 Occurrence Handle10459027

    PubMed  Google Scholar 

  7. JB Spies SM Ascher AR Roth J Kim EB Levy J Gomez-Jorge (2001) ArticleTitleUterine artery embolization for leiomyomata Obstet Gynecol 98 29–34 Occurrence Handle10.1016/S0029-7844(01)01382-5 Occurrence Handle1:STN:280:DC%2BD3MznsVanug%3D%3D Occurrence Handle11430952

    Article  CAS  PubMed  Google Scholar 

  8. WJ Walker JP Pelage (2002) ArticleTitleUterine artery embolisation for symptomatic fibroids: Clinical results in 400 women with imaging follow up Br J Obstet Gynaecol 109 1262–1272 Occurrence Handle1:STN:280:DC%2BD38nptFWitw%3D%3D

    CAS  Google Scholar 

  9. JP Pelage O Le Dref P Soyer et al. (2000) ArticleTitleFibroid-related menorrhagia: Treatment with superselective embolization of the uterine arteries and midterm follow-up Radiology 215 428–431 Occurrence Handle1:STN:280:DC%2BD3c3ls12rtA%3D%3D Occurrence Handle10796920

    CAS  PubMed  Google Scholar 

  10. A Laurent R Beaujeux M Wassef D Rüfenacht E Boschetti J Merland (1996) ArticleTitleTrisacryl gelatin microspheres for therapeutic embolization. I. Development and in vitro evaluation AJNR Am J Neuroradiol 17 533–540

    Google Scholar 

  11. R Beaujeux A Laurent M Wassef et al. (1996) ArticleTitleTrisacryl gelatin microspheres for therapeutic embolization. II. Preliminary clinical evaluation in tumors and arteriovenous malformations AJNR Am J Neuroradiol 17 541–548

    Google Scholar 

  12. M Bendzus R Klein R Burger M Warmuth-Metz E Hofmann L Solymosi (2000) ArticleTitleEfficacy of trisacryl gelatin microspheres versus polyvinyl alcohol particles in the preoperative embolization of meningiomas AJNR Am J Neuroradiol 21 255–261

    Google Scholar 

  13. C Derdeyn V Graves M Salamat A Rappe (1997) ArticleTitleCollagen-coated acrylic microspheres for embolotherapy: in vivo and in vitro characteristics AJNR Am J Neuroradiol 18 647–653

    Google Scholar 

  14. JP Pelage A Laurent M Wassef et al. (2002) ArticleTitleUterine artery embolization in the sheep: Comparison between polyvinyl alcohol particles and calibrated microspheres Radiology 224 436–445 Occurrence Handle12147840

    PubMed  Google Scholar 

  15. JP Pelage O Le Dref JP Beregi M Nonent Y Robert M Cosson D Jacob JB Truc A Laurent R Rymer (2003) ArticleTitleLimited uterine artery embolization with tris-acryl microspheres for uterine fibroids J Vasc Interv Radiol 14 15–20

    Google Scholar 

  16. JB Spies JE Benenati RL Worthington-Kirsch JP Pelage (2001) ArticleTitleInitial experience with trisacryl gelatin microspheres for uterine artery embolization for leiomyomata J Vasc Interv Radiol 12 1059–1063 Occurrence Handle1:STN:280:DC%2BD3MvptlCmtA%3D%3D Occurrence Handle11535768

    CAS  PubMed  Google Scholar 

  17. B McLucas L Adler R Perella (2001) ArticleTitleUterine fibroid embolization: Nonsurgical treatment for symptomatic fibroids J Am Coll Surg 192 95–105 Occurrence Handle10.1016/S1072-7515(00)00738-9 Occurrence Handle1:STN:280:DC%2BD3M%2FpsVynsw%3D%3D Occurrence Handle11192931

    Article  CAS  PubMed  Google Scholar 

  18. C Derdeyn C Moran D Cross H Dietrich R Dacey (1995) ArticleTitlePolyvinyl alcohol particle size and suspension characteristics AJNR Am J Neuroradiol 16 1335–1343

    Google Scholar 

  19. GP Siskin ME Tublin BF Stainken K Dowling EG Dolen (2001) ArticleTitleUterine artery embolization for the treatment of adenomyosis: Clinical response and evaluation with MR imaging AJR Am J Roentgenol 177 297–302 Occurrence Handle1:STN:280:DC%2BD3MvhtF2gug%3D%3D Occurrence Handle11461849

    CAS  PubMed  Google Scholar 

  20. JB Spies A Spector AR Roth CM Baker L Mauro K Murphy-Skrynarz (2002) ArticleTitleComplications after uterine artery embolization for leiomyomas Obstet Gynecol 100 873–880 Occurrence Handle10.1016/S0029-7844(02)02341-4 Occurrence Handle12423844

    Article  PubMed  Google Scholar 

  21. TJ Yeagley J Goldberg TA Klein J Bonn (2002) ArticleTitleLabial necrosis after uterine artery embolization for leiomyomata Obstet Gynecol 100 881–882 Occurrence Handle10.1016/S0029-7844(02)02273-1 Occurrence Handle12423845

    Article  PubMed  Google Scholar 

  22. P Amato AC Roberts (2001) ArticleTitleTransient ovarian failure: A complication of uterine artery embolization Fertil Steril 75 438–439 Occurrence Handle10.1016/S0015-0282(00)01678-2 Occurrence Handle1:STN:280:DC%2BD3M7ktlCmsQ%3D%3D Occurrence Handle11172854

    Article  CAS  PubMed  Google Scholar 

  23. CD Godfrey EA Zbella (2001) ArticleTitleUterine necrosis after uterine artery embolization for leiomyoma Obstet Gynecol 98 950–952 Occurrence Handle10.1016/S0029-7844(01)01483-1 Occurrence Handle1:STN:280:DC%2BD3MnltFCntw%3D%3D Occurrence Handle11704217

    Article  CAS  PubMed  Google Scholar 

  24. NH Stringer T Grant J Park L Oldham (2000) ArticleTitleOvarian failure after uterine artery embolization for treatment of myomas J Am Assoc Gynecol Laparosc 7 395–400 Occurrence Handle1:STN:280:DC%2BD3cvptlyntQ%3D%3D Occurrence Handle10924636

    CAS  PubMed  Google Scholar 

  25. A Vashisht JWW Studd AH Carey et al. (2000) ArticleTitleFibroid embolisation: A technique not without significant complications Br J Obstet Gynaecol 107 1166–1170 Occurrence Handle1:STN:280:DC%2BD3cvkvV2rsA%3D%3D

    CAS  Google Scholar 

  26. S Goodwin B McLucas M Lee et al. (1999) ArticleTitleUterine artery embolization for the treatment of uterine leiomyomata: Midterm results J Vasc Interv Radiol 10 1159–1165 Occurrence Handle1:STN:280:DyaK1MvlsVeitw%3D%3D Occurrence Handle10527191

    CAS  PubMed  Google Scholar 

  27. S Goodwin S Vedantham B McLucas A Forno R Perrella (1997) ArticleTitlePreliminary experience with uterine artery embolization for uterine fibroids J Vasc Interv Radiol 8 517–526 Occurrence Handle1:STN:280:ByiA2snksFE%3D Occurrence Handle9232565

    CAS  PubMed  Google Scholar 

  28. SC Goodwin WJ Walker (1998) ArticleTitleUterine artery embolization for the treatment of uterine fibroids Curr Opin Obstet Gynecol 10 315–320 Occurrence Handle10.1097/00001703-199808000-00006 Occurrence Handle1:STN:280:DyaK1czos1emsA%3D%3D Occurrence Handle9719883

    Article  CAS  PubMed  Google Scholar 

  29. J Ravina D Herbreteau N Ciraru-Vigneron et al. (1995) ArticleTitleArterial embolisation to treat uterine myomata Lancet 346 671–672 Occurrence Handle10.1016/S0140-6736(95)92282-2 Occurrence Handle1:STN:280:ByqA1cjnslY%3D Occurrence Handle7544859

    Article  CAS  PubMed  Google Scholar 

  30. J Spies A Scialli R Jha et al. (1999) ArticleTitleInitial results from uterine fibroid embolization for symptomatic leiomyomata J Vasc Interv Radiol 10 1149–1157 Occurrence Handle1:STN:280:DyaK1MvlsVeitg%3D%3D Occurrence Handle10527190

    CAS  PubMed  Google Scholar 

  31. EA Bradley JF Reidy RG Forman J Jarosz PR Braude (1998) ArticleTitleTranscatheter uterine embolisation to treat large uterine fibroids Br J Obstet Gynaecol 105 235–240 Occurrence Handle1:STN:280:DyaK1c7mt1Citw%3D%3D Occurrence Handle9501794

    CAS  PubMed  Google Scholar 

  32. RL Worthington-Kirsch GL Popky FL Hutchins (1998) ArticleTitleUterine arterial embolization for the management of leiomyomas: Quality-of-life assessment and clinical response Radiology 208 625–629 Occurrence Handle1:STN:280:DyaK1czptVSlsA%3D%3D Occurrence Handle9722838

    CAS  PubMed  Google Scholar 

  33. PE Andersen N Lund P Justesen T Munk B Elle C Floridon (2001) ArticleTitleUterine artery embolization of symptomatic uterine fibroids: Initial success and short-term results Acta Radiol 42 234–238 Occurrence Handle10.1034/j.1600-0455.2001.042002234.x Occurrence Handle1:STN:280:DC%2BD3M7mvVGksw%3D%3D Occurrence Handle11259954

    Article  CAS  PubMed  Google Scholar 

  34. RK Ryu HB Chrisman RA Omary et al. (2001) ArticleTitleThe vascular impact of uterine artery embolization: Prospective sonographic assessment of ovarian arterial circulation J Vasc Interv Radiol 12 1171–1174

    Google Scholar 

  35. HB Chrisman MB Saker RK Ryu et al. (2000) ArticleTitleThe impact of uterine fibroid embolization on resumption of menses and ovarian function J Vasc Interv Radiol 11 699–703 Occurrence Handle1:STN:280:DC%2BD3M%2Fhs1KksQ%3D%3D Occurrence Handle10877413

    CAS  PubMed  Google Scholar 

  36. JP Pelage WJ Walker O Le Dref R Rymer (2003) ArticleTitleOvarian artery: Angiographic appearance, embolization and relevance to uterine fibroid embolization Cardiovasc Intervent Radiol 26 227–233

    Google Scholar 

  37. SJ Smith LE Sewall A Handelsman (1999) ArticleTitleA clinical failure of uterine fibroid embolization due to adenomyosis J Vasc Interv Radiol 10 1171–1174 Occurrence Handle1:STN:280:DyaK1MvlsVeitQ%3D%3D Occurrence Handle10527193

    CAS  PubMed  Google Scholar 

  38. M Bazot E Darai J Rouger R Detchev A Cortez S Uzan (2002) ArticleTitleLimitations of transvaginal sonography for the diagnosis of adenomyosis, with histopathological correlation Ultrasound Obstet Gynecol 20 605–611 Occurrence Handle10.1046/j.1469-0705.2002.00852.x Occurrence Handle1:STN:280:DC%2BD38jjtFKmtA%3D%3D Occurrence Handle12493051

    Article  CAS  PubMed  Google Scholar 

  39. JY Byun SE Kim BG Choi GY Ko SE Jung KH Choi (1999) ArticleTitleDiffuse and focal adenomyosis: MR imaging findings Radiographics 19 S161–S170 Occurrence Handle10517452

    PubMed  Google Scholar 

  40. JB Spies (2003) ArticleTitleUterine artery embolization for fibroids: Understanding the technical causes of failure J Vasc Interv Radiol 14 11–14

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Société Française d’Imagerie CardioVasculaire, France

    Francis Joffre

  2. Collège de Radiologie Interventionnelle, France

    Jean-Michel Tubiana

  3. Radiologie, Hôpital Ambroise Paré, Boulogne, France

    Jean-Pierre Pelage

Authors
  1. Francis Joffre
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jean-Michel Tubiana
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jean-Pierre Pelage
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

Groupe FEMIC*

Corresponding author

Correspondence to Jean-Pierre Pelage.

Additional information

1;*See Appendix for list of members.

Correspondene to: J.-P. Pelage; email:

Appendix. Members of the FEMIC Study Group: Participating Centers

Appendix. Members of the FEMIC Study Group: Participating Centers

Centre Hospitalier Universitaire, Bordeaux (H. Trillaud, G. Gorin)

Centre Hospitalier Universitaire, Brest (M. Nonent)

Clinique du Parc, Castelnau le Lez (O. Serres-Cousiné)

Hôpital Beaujon, Clichy (A. Sibert)

Hôpital Henri Mondor, Créteil (H. Kobeiter)

Centre Hospitalier, Lagny (A. Ferrario)

Centre Hospitalier Universitaire, Lille (J.P. Beregi)

Centre Hospitalier Universitaire, Limoges (A. Maubon)

Centre Hospitalier Universitaire, Marseille (J.M. Bartoli, A. Fig. 2)

Centre Hospitalier Arnaud de Villeneuve, Montpellier (H. Vernhet, K. Giobbini)

Polyclinique du Languedoc, Narbonne (O. Callede, C. Pinatel

Hôpital Européen Georges Pompidou, Paris (M. Sapoval)

Hôpital Lariboisière, Paris (J.P. Pelage, O. Le Dref, D. Jacob, R. Rymer)

Centre Hospitalier René Dubos, Pontoise (P. Garance, J.M. Murray)

Centre Hospitalier, Sens (M. Henry)

Centre Hospitalier Universitaire, Strasbourg (R. Beaujeux, M. Greget, J. Tongio)

Centre Hospitalier Universitaire, Tours (D. Herbreteau, S. Gallas)

Centre Hospitalier, Troyes (J.P. Chancrin)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Joffre, F., Tubiana, JM., Pelage, JP. et al. FEMIC (Fibromes Embolisés aux MICrosphères calibrées): Uterine Fibroid Embolization using Tris-acryl Microspheres. A French Multicenter Study. CVIR 27, 600–606 (2004). https://doi.org/10.1007/s00270-004-0078-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-004-0078-5

Search

Navigation