The use of degradable microspheres for uterine fibroid embolization (UFE) have demonstrated “excellent” infarction rates and fibroid volume reduction in the results of a recent study. Presented at the European Conference on Embolotherapy (ET; 11–14 June, Porto, Portugal), speaker Paul Lohle (Elisabeth-Tweesteden Ziekenhuis, Tilburg, The Netherlands) said the shift from permanent to temporary embolic material is of growing interest amidst increasing concern and questions—not only among patients—over “foreign materials and plastics” remaining in the body post-UFE. Lohle states that regulatory instances worry about materials left behind that may be subject to reaction from our immune system.
Driving their area of research, Lohle shared that studies have suggested lower pregnancy rates and premature menopause following UFE with permanent particles. “The disappearance of degradable microspheres after UFE offers the possibility of vessel restoration and uterine function, protecting the endometrium and allowing for vessel dilation during pregnancy for foetal growth, as well as lowering the risk of permanent ovarian damage or premature menopause,” detailed Lohle. He added that the degradation of the microspheres could also be beneficial in the event of fibroid recurrence requiring repeat UFE.
Lohle and colleagues study collected prospectively data from 51 patients between September 2023 and January 2025 with symptomatic uterine fibroids treated with 500–700µm followed by 700–900µm Nexsphere (Nextbiomedical) degradable microspheres. Patients underwent intentional unilateral or bilateral UFE based on contrast-enhanced magnetic resonance imaging (MRI) characteristics or angiographic features. Baseline and follow-up clinical results were collected by measuring health-related quality of life (HRQoL) metrics using the validated uterine fibroid symptom health-related quality of life (UFS-QOL) questionnaire. Fibroid and uterine volume, and fibroid infarction rate were assessed using T1-, T2- and contrast MRI.
Patients had an average age of 48 years, with an average fibroid volume of 390cc and uterine volume of 821cc, while two patients had fibroids accompanied by adenomyosis. Of the 51 patients treated, Lohle and colleagues collected three-month follow-up data from 43 patients.
Three-month follow-up MRI demonstrated high fibroid infarction rates (95%), as well as “significant” fibroid- and uterine-volume reduction: -158cm3 or 44% and -324cm3 or 37%, respectively.
Regarding quality of life, Lohle stated that their results show “a significant improvement in quality of life in our patients”. Key improvements in HRQoL metrics were reported across symptom severity, reported energy and the ability to engage in day-to-day activities.
Lohle compared their data to those collected in Kichang Han et al’s randomised controlled trial in South Korea which compared permanent agents with Nexsphere degradable microspheres. Han and colleagues found no significant difference between pain score or complete fibroid infarction, however found a significantly higher rate of recanalisation with Nexsphere microspheres compared with the permanent agents post-UFE (70% vs. 17%, respectively).
“Our preliminary results for UFE using a new degradable microsphere confirms its safety and efficacy with excellent fibroid infarction rates,” stated Lohle highlighting clinical improvement in the “vast majority” of patients.
