Porous gelatin particles for uterine artery embolization: an experimental study of intra-arterial distribution, uterine necrosis, and inflammation in a porcine model

Cardiovasc Intervent Radiol. 2010 Oct;33(5):1001-8. doi: 10.1007/s00270-010-9935-6. Epub 2010 Jul 15.

Abstract

Purpose: We evaluated the location of porous gelatin particles (GP; Gelpart; Nippon Kayaku/Astellas, Tokyo, Japan) within the arterial vasculature and their acute effects on uterine necrosis and inflammation after uterine artery embolization (UAE) in swine.

Materials and methods: Adult nonpregnant pigs (n = 6) were allocated to either 1- (n = 3) or 2-mm GP (n = 3). Superselective and bilateral embolization of the uterine arteries was performed. All animals were killed 1 week after UAE. Macroscopic and microscopic findings, including the level of arterial occlusion and their effect on uterine necrosis and inflammation, were analyzed.

Results: All UAE procedures were completed without severe complications. The macroscopic necrosis was seen in two animals in the 2-mm group with an extent of <50%. The location of the occluded arteries did not differ significantly between groups. The median diameters of the occluded arteries were 449 microm (95% confidence interval [CI] 417-538 microm) in the 1-mm GP group and 484 microm (95% CI 370-560 microm) in the 2-mm GP group. As for microscopic necrosis, no statistically significant difference was observed. The qualitative inflammatory reaction was significantly greater in the 2-mm GP group than in the 1-mm group (p < 0.001).

Conclusions: Both 1- and 2-mm GP occluded the arteries relevant to the target diameter for UAE in porcine uterus, presumably due to the plastic deformity. Both sizes of GP were associated with limited areas of necrosis; however, evaluation of inflammatory reaction was preliminary. Further study with adequate evaluation of inflammatory reactions is suggested.

Publication types

  • Comparative Study

MeSH terms

  • Angiography
  • Animals
  • Biopsy, Needle
  • Chi-Square Distribution
  • Disease Models, Animal
  • Female
  • Gelatin / pharmacokinetics*
  • Gelatin / pharmacology
  • Immunohistochemistry
  • Inflammation / pathology
  • Necrosis / pathology
  • Particle Size
  • Porosity
  • Random Allocation
  • Risk Factors
  • Statistics, Nonparametric
  • Swine
  • Uterine Artery / diagnostic imaging
  • Uterine Artery / drug effects*
  • Uterine Artery / pathology
  • Uterine Artery Embolization / adverse effects
  • Uterine Artery Embolization / methods*
  • Uterus / drug effects
  • Uterus / pathology*

Substances

  • Gelatin