OBJECTIVE: To compare the long-term evolution of uterine arteries after embolization with the two most commonly used embolic agents for fibroid embolization: nonspherical polyvinyl alcohol (PVA) particles and trisacryl gelatin microspheres (TGMS). DESIGN: Prospective study. SETTING: University-based interventional radiology, pathology, and reproductive physiology units. ANIMAL(S): Two groups of 10 sheep embolized in the uterine artery. INTERVENTION(S): Embolization of the uterine artery with either 600-1000 microm nonspherical polyvinyl alcohol (PVA) particles or with 700-900 microm trisacryl gelatin microspheres (TGMS). Animals were synchronized and naturally inseminated. Animals were killed at 26 months. MAIN OUTCOME MEASURE(S): Uteri were examined pathologically for vessel size, site of occlusion, recanalization rate of vessels, and particle location within the vascular wall. RESULT(S): The PVA particles were more numerous in the vessels' lumen than the TGMS particles (13.3 +/- 20.8 vs. 2.5 +/- 2.7), were located more proximally than TGMS (97% vs. 68% in the trunk and first branches of the uterine artery), and were found almost exclusively in the intima (99.2%). In contrast, 54.4% of the TGMS particles were found in the intima, and 45.6% partially or totally excluded. The rate of recanalization was not statistically significantly different for PVA and TGMS (65.2% vs. 60.6%). CONCLUSION(S): The long-term evolution of uterine arteries was different after uterine artery embolization with PVA and TGMS because PVA particles formed large-sized aggregates that occluded proximal vessels and remained in the vessel intima. Microspheres occluded more distal vessels, and about 50% of them were partially or totally excluded from the vessel.
OBJECTIVE: To compare the long-term evolution of uterine arteries after embolization with the two most commonly used embolic agents for fibroid embolization: nonspherical polyvinyl alcohol (PVA) particles and trisacryl gelatin microspheres (TGMS). DESIGN: Prospective study. SETTING: University-based interventional radiology, pathology, and reproductive physiology units. ANIMAL(S): Two groups of 10 sheep embolized in the uterine artery. INTERVENTION(S): Embolization of the uterine artery with either 600-1000 microm nonspherical polyvinyl alcohol (PVA) particles or with 700-900 microm trisacryl gelatin microspheres (TGMS). Animals were synchronized and naturally inseminated. Animals were killed at 26 months. MAIN OUTCOME MEASURE(S): Uteri were examined pathologically for vessel size, site of occlusion, recanalization rate of vessels, and particle location within the vascular wall. RESULT(S): The PVA particles were more numerous in the vessels' lumen than the TGMS particles (13.3 +/- 20.8 vs. 2.5 +/- 2.7), were located more proximally than TGMS (97% vs. 68% in the trunk and first branches of the uterine artery), and were found almost exclusively in the intima (99.2%). In contrast, 54.4% of the TGMS particles were found in the intima, and 45.6% partially or totally excluded. The rate of recanalization was not statistically significantly different for PVA and TGMS (65.2% vs. 60.6%). CONCLUSION(S): The long-term evolution of uterine arteries was different after uterine artery embolization with PVA and TGMS because PVA particles formed large-sized aggregates that occluded proximal vessels and remained in the vessel intima. Microspheres occluded more distal vessels, and about 50% of them were partially or totally excluded from the vessel.
Authors: Jingjie Hu; Hassan Albadawi; Brian W Chong; Amy R Deipolyi; Rahul A Sheth; Ali Khademhosseini; Rahmi Oklu Journal: Adv Mater Date: 2019-06-06 Impact factor: 30.849
Authors: H Zhao; C Zheng; G Feng; Y Zhao; H Liang; H Wu; G Zhou; B Liang; Y Wang; X Xia Journal: AJNR Am J Neuroradiol Date: 2012-08-02 Impact factor: 3.825
Authors: Carmen Gacchina Johnson; Karun V Sharma; Elliot B Levy; David L Woods; Aaron H Morris; John D Bacher; Andrew L Lewis; Bradford J Wood; Matthew R Dreher Journal: J Vasc Interv Radiol Date: 2015-08-28 Impact factor: 3.464
Authors: Aymara Mas; Marta Tarazona; Joana Dasí Carrasco; Gloria Estaca; Ignacio Cristóbal; Javier Monleón Journal: Int J Womens Health Date: 2017-09-05