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The effects of uterine artery embolization with a new degradable microsphere in an experimental study

Bengtsson, Johan LU ; Cwikiel, Wojciech LU ; Sundgren, Pia C. LU ; Karlstam, Erika; Gavier-Widén, Dolores and Keussen, Inger LU (2017) In Acta Radiologica 58(11). p.1334-1341
Abstract

Background Transarterial particle embolization is a common treatment of uterine fibroids, aiming to obtain ischemia resulting in shrinking of the fibroid with preservation of normal uterine tissue. Embolization with non-degradable microspheres is established, but causes permanent occlusion of the arteries, affecting both the uterus as well as the fibroids. Purpose To evaluate in vivo degradation, local tissue effects, and possible recanalization following intra-arterial deposition of the new, degradable starch microspheres (DSM), in a short-term experimental pilot study. Material and Methods Under general anesthesia, unilateral transarterial embolization of the uterine artery (UA) with DSM 500-700 μm was performed in five female sheep.... (More)

Background Transarterial particle embolization is a common treatment of uterine fibroids, aiming to obtain ischemia resulting in shrinking of the fibroid with preservation of normal uterine tissue. Embolization with non-degradable microspheres is established, but causes permanent occlusion of the arteries, affecting both the uterus as well as the fibroids. Purpose To evaluate in vivo degradation, local tissue effects, and possible recanalization following intra-arterial deposition of the new, degradable starch microspheres (DSM), in a short-term experimental pilot study. Material and Methods Under general anesthesia, unilateral transarterial embolization of the uterine artery (UA) with DSM 500-700 μm was performed in five female sheep. The animals underwent renewed angiography at different intervals after embolization (19-65 h) and were subsequently sacrificed. Histological examination was performed. Results Embolization with absent flow in the UA could be completed in five of six animals. At final angiographic evaluation, recanalization of the embolized arteries was evident in three sheep. At the gross postmortem examination, edema and discoloration indicating ischemia of the uterus at the embolized side, was observed in all the sheep. At histopathological examination, different stages of DSM degradation in the arterial branches were observed in both endometrium and myometrium. Mild-to-moderate vasculitis and mild-to-extensive ischemic changes were present along with degeneration of the uterine glands. Conclusion This short-term pilot study proved efficacy of embolization with DSM causing ischemic changes in the embolized organ, but also degradation of the DSM with subsequent recanalization of the embolized arteries.

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author
organization
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type
Contribution to journal
publication status
published
subject
keywords
experimental study, microspheres, Uterine artery embolization, uterus
in
Acta Radiologica
volume
58
issue
11
pages
1334 - 1341
publisher
John Wiley & Sons
external identifiers
  • scopus:85029703842
  • wos:000410933900008
ISSN
0284-1851
DOI
10.1177/0284185117694510
language
English
LU publication?
yes
id
a92c122a-1a21-4dde-9c89-485b760bad4d
date added to LUP
2017-10-06 10:22:14
date last changed
2018-01-16 13:21:21
@article{a92c122a-1a21-4dde-9c89-485b760bad4d,
  abstract     = {<p>Background Transarterial particle embolization is a common treatment of uterine fibroids, aiming to obtain ischemia resulting in shrinking of the fibroid with preservation of normal uterine tissue. Embolization with non-degradable microspheres is established, but causes permanent occlusion of the arteries, affecting both the uterus as well as the fibroids. Purpose To evaluate in vivo degradation, local tissue effects, and possible recanalization following intra-arterial deposition of the new, degradable starch microspheres (DSM), in a short-term experimental pilot study. Material and Methods Under general anesthesia, unilateral transarterial embolization of the uterine artery (UA) with DSM 500-700 μm was performed in five female sheep. The animals underwent renewed angiography at different intervals after embolization (19-65 h) and were subsequently sacrificed. Histological examination was performed. Results Embolization with absent flow in the UA could be completed in five of six animals. At final angiographic evaluation, recanalization of the embolized arteries was evident in three sheep. At the gross postmortem examination, edema and discoloration indicating ischemia of the uterus at the embolized side, was observed in all the sheep. At histopathological examination, different stages of DSM degradation in the arterial branches were observed in both endometrium and myometrium. Mild-to-moderate vasculitis and mild-to-extensive ischemic changes were present along with degeneration of the uterine glands. Conclusion This short-term pilot study proved efficacy of embolization with DSM causing ischemic changes in the embolized organ, but also degradation of the DSM with subsequent recanalization of the embolized arteries.</p>},
  author       = {Bengtsson, Johan and Cwikiel, Wojciech and Sundgren, Pia C. and Karlstam, Erika and Gavier-Widén, Dolores and Keussen, Inger},
  issn         = {0284-1851},
  keyword      = {experimental study,microspheres,Uterine artery embolization,uterus},
  language     = {eng},
  month        = {11},
  number       = {11},
  pages        = {1334--1341},
  publisher    = {John Wiley & Sons},
  series       = {Acta Radiologica},
  title        = {The effects of uterine artery embolization with a new degradable microsphere in an experimental study},
  url          = {http://dx.doi.org/10.1177/0284185117694510},
  volume       = {58},
  year         = {2017},
}