Safety and Clinical Outcomes of Two-Session Catheter-Directed Sclerotherapy Using Ethanol for Endometrioma

Overview

Journal Cardiovasc Intervent Radiol

Specialty Cardiology & Vascular Diseases

Date 2024 Mar 26

PMID 38528174

Authors

Chu Hui Zeng

Chuan Wu Cao

Ji Hoon Shin

Gun Ha Kim

Sung Hoon Kim

Sa Ra Lee

Shin Wha Lee

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the safety and clinical outcome of two-session catheter-directed sclerotherapy (CDS) with 99% ethanol in patients with endometrioma.

Materials And Methods: This prospective study was approved by the institutional review board with written informed consent obtained from all participants and was registered on clinicaltrial.gov. Consecutive patients with ovarian endometrioma between June 2020 and March 2023 were prospectively evaluated for two sessions of CDS. After successful transvaginal ultrasound-guided puncture of the endometrioma, the biopsy needle was exchanged for a 7- or 8.5-F catheter for aspiration and ethanol injection. The catheter was retained in situ for a second session the next day. Endometrioma volume was measured on ultrasound before and 1, 3, and 6 months after CDS, and volume reduction ratio (VRR) was calculated. Serum anti-Müllerian hormone (AMH) was measured before and 6 months after CDS to assess ovarian reserve.

Results: Thirty-one endometriomas in 22 patients (mean age, 31.0 years; range, 19-44 years) were treated; 28 endometriomas were successfully treated with two-session CDS, while one session was incomplete in three endometriomas in three patients due to contrast medium leakage or pain. Minor procedure-related complications developed in four patients and resolved spontaneously before discharge on the same day of the second session. No recurrence was identified during follow-up. At the 6-month follow-up, the mean endometrioma diameter decreased from 5.5 ± 1.7 to 1.4 ± 0.9 cm (P < 0.001), and the serum AMH level was lowered without statistical significance (1.37 ± 0.96 ng/mL vs. 1.18 ± 0.92 ng/mL; P = 0.170). VRRs at 1, 3, and 6 months after CDS were 84.3 ± 13.7%, 94.3 ± 5.8%, and 96.4 ± 4.7%, respectively.

Conclusion: Two-session CDS with 99% ethanol is safe, feasible, and effective for treating endometrioma with the ovarian function well preserved.

Citing Articles

Ethanol Sclerotherapy for Endometriomas in Infertile Women: A Narrative Review.

Sukur Y, Aslan B, Varli B, Ozcan P, Daniilidis A, Kalaitzopoulos D J Clin Med. 2025; 13(24.

PMID: 39768471 PMC: 11727901. DOI: 10.3390/jcm13247548.

The Catheter Method in Sclerotherapy in the Management of Ovarian Endometriomas.

Keckstein J, Keckstein S Cardiovasc Intervent Radiol. 2024; 47(7):910-911.

PMID: 38886206 DOI: 10.1007/s00270-024-03775-0.

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