Uterine Artery Occlusion for Fibroid Related Bleeding

An Evaluation of a Doppler-Guided Uterine Artery Occlusion Device as Treatment for the Reduction of Fibroid-Associated Bleeding

The primary objective of this study is to evaluate the safety and effectiveness of Doppler guided Uterine Artery Occlusion (D-UAO) as treatment for the reduction of fibroid-associated symptoms.

Study Overview

• Status: Terminated
• Conditions: Uterine Fibroids; Menorrhagia
• Intervention / Treatment: Device: Doppler-Guided Uterine Artery Occlusion Device

Detailed Description

DUAO is intended for bilateral occlusion of the uterine arteries

• Study Type: Interventional
• Enrollment (Actual): 91
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Denmark
  • Viborg, Denmark, DK-8800
    • Viborg County Hospital
• France
  • Angers cedex, France, 49033
    • University Hospital
  • Clamart Cedex, France, 92414
    • Service de Gynecologie Obsterique, Hopital Antoine Beclere
  • Dunkerque, France, 59430
    • Maternite les Bazennes
  • Lille Cedex, France, 59037
    • CHRU de Lille, Hopital Jeanne de Flandre
• Germany
  • Erlangen, Germany, 91054
    • Universitaeklinikum Erlangen
  • Tubingen, Germany, 72076
    • Universitäts-Frauenklinik Tübingen
• Netherlands
  • Amsterdam, Netherlands, 1081 HV
    • VU Medical Center
• Norway
  • Oslo, Norway, N-0407
    • Ullevaal University
• Switzerland
  • Bern, Switzerland, 3012
    • Universitäts-Frauenklinik
• United Kingdom
  • Bradford, United Kingdom, BD9 6RJ
    • M1 Maternity, Bradford Royal Infirmary
  • Hull, United Kingdom, HU3 2JZ
    • Hull and East Yorkshire Women & Children Hospital
  • London, United Kingdom, WC1E 6DH
    • Elizabeth Garret Anderson Hospital
  • Margate, United Kingdom, CT9 4AN
    • Queen Elizabeth the Queen Mother Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 25 years to 50 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• 25 to 50 years of age
• Subject has a negative urine or blood pregnancy test prior to the procedure. At the time of enrollment to the study, the subject has no intent of further childbearing and intends to use appropriate contraception throughout the first 12 months of the study period (unless sterilized)
• Normal pap smear within 36 months of study procedure (most recent)
• Cervix suitable for tenaculum placement as determined by pelvic exam (adequate length of cervix, absence of cervical fibroid/lower fibroid to prevent clamp placement)
• At least one intra-mural or sub-serosal or sub-mucosal uterine fibroid with a minimum diameter of greater than or equal to 3 cm, and all fibroids with a diameter less than or equal to 8cm with a prevailing pathology (e.g., as opposed to adenomyosis) of fibroids determined through ultrasound
• Symptomatic subject presenting with at least one of the following fibroid symptoms: pelvic pressure, menorrhagia, metrorrhagia, pelvic pain, increasing abdominal girth or dyspareunia due to fibroids.
• Subject has evidence of bilateral ureteric flow
• Subject agrees to participate in the study, including completion of all study-related procedures and evaluations, and documents this agreement by signing the Ethics Committee-approved informed consent.

Exclusion Criteria:

• Pregnancy as confirmed by positive urine or blood pregnancy test
• Menopausal as defined by elevated follicle-stimulating hormone (FSH) and decreased oestradiol hormone levels as determined by the hospital local laboratory reference range criteria
• Presence of any pedunculated sub-mucosal or pedunculated sub-serosal fibroid(s) as determined by MRI, ultrasound or hysteroscopy
• Presence of an intra-uterine device (IUD)
• Any hydronephrosis as determined on renal ultrasound prior to the procedure
• Clinical history of any thrombo-embolic disease or known thrombophilia
• Blood Urine Nitrogen (BUN) greater than 7.2mmol/L* and/or serum creatinine greater than 106μmol/L* unresolved with change in diet or hydration
• History or current evidence of gynecologic malignancy (confirmed by hysteroscopy or endometrial biopsy), atypical endometrial hyperplasia, or chronic pelvic inflammatory disease
• Pelvic mass outside the uterus other than uterine fibroids
• Any current acute or chronic systemic infection or localized pelvic infection, including a urinary tract infection
• Use of Gonadotropin-Releasing Hormone (GnRH) agonist, danozol or mifepristone within 6-months prior to the start of the study procedure
• Using anticoagulation therapy (except over the counter treatments (e.g. aspirin)), or have an underlying bleeding disorder
• Unsuitable for MRI examination (e.g. severe claustrophobia, non-MRI-compatible implanted metalloid devices)
• Prior endometrial ablation, uterine artery embolization, or uterine artery ligation
• Poor procedural candidate due to medical conditions as determined by the investigator (e.g. anesthesia class, renal insufficiency, heart disease);

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: 1; DUAO Device	Device: Doppler-Guided Uterine Artery Occlusion Device; For bilateral occlusion of the uterine arteries; Other Names: floSTAT

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Lack of surgical re-intervention	Post-op through end of study

Secondary Outcome Measures

Outcome Measure	Time Frame
Percentage of subjects with improvement in Uterine Fibroid Symptom Quality of Life (UFS-QOL) Symptom Severity and Health Related Quality of Life (HRQL) scores.	6, 12 and 24 months
Mean improvement in UFS-QOL Symptom Severity and HRQL transformed scores.	6, 12 and 24 months
Mean HRQL subscales.	6, 12 and 24 months
Percentage of subjects with reduction of 50% or greater in Pictorial Blood Loss Assessment Chart (PBLAC) score.	6 and 12 months
Mean change in PBLAC scores.	Baseline to 6 and 12 months
Percentage of subjects with decrease in fibroid load based on independent MRI review.	6 months
Percentage of subjects with maintenance of menses as defined by continuation of menstrual cycles without an interruption of three consecutive months	12 months
Percentage of subjects with procedural satisfaction as defined by responses of either satisfied or very satisfied.	12 months
Lack of surgical re-intervention.	24 months
Pain score	Discharge or 24-hour post clamp removal, whichever is earlier
Days to normal activities (household, work and sexual intercourse)	Post procedure
Euro-QOL expressed as change from baseline for each of the 6 domains and Visual Analogue Scale (VAS)	1, 3, 6 and 12 months
Nights in hospital	Total and post procedure

Collaborators and Investigators

• Sponsor: Ethicon, Inc.

Study record dates

Study Major Dates

• Study Start: April 1, 2007
• Primary Completion (Actual): December 1, 2009
• Study Completion (Actual): December 1, 2009

Study Registration Dates

• First Submitted: July 3, 2007
• First Submitted That Met QC Criteria: July 3, 2007
• First Posted (Estimate): July 4, 2007

Study Record Updates

• Last Update Posted (Estimate): March 9, 2011
• Last Update Submitted That Met QC Criteria: March 8, 2011
• Last Verified: March 1, 2011

More Information

Terms related to this study

• Keywords: Menorrhagia; Fibroids; Menorrhagia associated with uterine fibroids
• Additional Relevant MeSH Terms: Pathologic Processes; Neoplasms, Connective and Soft Tissue; Neoplasms by Histologic Type; Neoplasms; Uterine Diseases; Hemorrhage; Connective Tissue Diseases; Neoplasms, Connective Tissue; Menstruation Disturbances; Neoplasms, Muscle Tissue; Uterine Hemorrhage; Leiomyoma; Myofibroma; Menorrhagia
• Other Study ID Numbers: 300-06-008