title: Recanalization and particle exclusion after embolization of uterine arteries in sheep: a long-term study.
abstract: 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).
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  University-based interventional radiology, pathology, and reproductive physiology units.
  
  
  METHODS
  Two groups of 10 sheep embolized in the uterine artery.
  
  
  METHODS
  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.
  
  
  METHODS
  Uteri were examined pathologically for vessel size, site of occlusion, recanalization rate of vessels, and particle location within the vascular wall.
  
  
  RESULTS
  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%).
  
  
  CONCLUSIONS
  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.affiliation: Department of Interventional Neuroradiology, AP-HP, Lariboisière Hospital, Paris, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Laurent
authors.forename: Michel
authors.initials: M
authors.lastname: Wassef
authors.forename: Julien
authors.initials: J
authors.lastname: Namur
authors.forename: Jacques
authors.initials: J
authors.lastname: Martal
authors.forename: Denis
authors.initials: D
authors.lastname: Labarre
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Pelage
mesh_terms: D000180:Acrylic Resins / Q000008:administration & dosage* / Q000009:adverse effects / Q000378:metabolism; D000818:Animals; D001158:Arteries / Q000378:metabolism / Q000473:pathology; D005260:Female; D005298:Fertility; D005549:Foreign-Body Reaction / Q000209:etiology / Q000473:pathology; D005780:Gelatin / Q000008:administration & dosage* / Q000009:adverse effects / Q000378:metabolism; D023421:Models, Animal; D010316:Particle Size; D011142:Polyvinyl Alcohol / Q000008:administration & dosage* / Q000009:adverse effects / Q000378:metabolism; D011247:Pregnancy; D011446:Prospective Studies; D012756:Sheep; D013997:Time Factors; D055357:Uterine Artery Embolization / Q000009:adverse effects / Q000379:methods*; D014599:Uterus / Q000098:blood supply* / Q000473:pathology / Q000503:physiopathology
chemical_list: D000180:Acrylic Resins; C496735:trisacryl gelatin microspheres; D005780:Gelatin; D011142:Polyvinyl Alcohol