PURPOSE: To compare the degree of uterine damage caused by uterine artery embolization (UAE) with gelatin sponge particles (GSPs) and N-butyl cyanoacrylate (NBCA) in swine. MATERIALS AND METHODS: Fifteen swine were divided into three groups of five according to embolic material: group A (1-mm GSPs), group B (NBCA:Lipiodol = 1:1), and group C (NBCA:Lipiodol = 1:7). The uterine arteries were completely occluded bilaterally. The uteri were removed 3 days after embolization, and radiographs of the removed specimens were obtained in groups B and C to evaluate the distribution of the NBCA. The macroscopic necrosis rates of the uteri were calculated, and the uteri were evaluated histologically. RESULTS: Uterine necrosis rates were 4.9 ± 6.1, 1.3 ± 3.3, and 41.4 ± 28.8 % in groups A, B, and C, respectively, and were significantly higher in group C than in groups A (p = 0.0014) and B (p < 0.001). Uterine necroses were found in all 9 of the uteri with distal distributions of NBCA, and in only 1 of the 11 uteri with proximal distributions of NBCA. CONCLUSIONS: Dilute NBCA caused more damage to the uteri than GSPs and concentrated NBCA did. Distal embolization using NBCA caused large necroses. Therefore, proximal UAE using concentrated NBCA should be considered in clinical situations.
PURPOSE: To compare the degree of uterine damage caused by uterine artery embolization (UAE) with gelatin sponge particles (GSPs) and N-butyl cyanoacrylate (NBCA) in swine. MATERIALS AND METHODS: Fifteen swine were divided into three groups of five according to embolic material: group A (1-mm GSPs), group B (NBCA:Lipiodol = 1:1), and group C (NBCA:Lipiodol = 1:7). The uterine arteries were completely occluded bilaterally. The uteri were removed 3 days after embolization, and radiographs of the removed specimens were obtained in groups B and C to evaluate the distribution of the NBCA. The macroscopic necrosis rates of the uteri were calculated, and the uteri were evaluated histologically. RESULTS: Uterine necrosis rates were 4.9 ± 6.1, 1.3 ± 3.3, and 41.4 ± 28.8 % in groups A, B, and C, respectively, and were significantly higher in group C than in groups A (p = 0.0014) and B (p < 0.001). Uterine necroses were found in all 9 of the uteri with distal distributions of NBCA, and in only 1 of the 11 uteri with proximal distributions of NBCA. CONCLUSIONS: Dilute NBCA caused more damage to the uteri than GSPs and concentrated NBCA did. Distal embolization using NBCA caused large necroses. Therefore, proximal UAE using concentrated NBCA should be considered in clinical situations.