Resorbable embolic

Resorbable Embolization Materials for Uterine Fibroid Embolization 193... 

It may be hypothesized that, compared to materials which are slowly degradable, resorbable embolics would be more able to restore uterine artery integrity. A gelatin sponge is mainly used to perform hemostatic embolization [19]. This biodegradable intravascular embolization agent has also been successfully used for fibroid embolization. Mid-term results seem to be comparable to those obtained with non-spherical PVA particles or calibrated microspheres [12]. 

Henry Howell (1860-1945) and is extracted nowadays from the mucous membranes in the small intestine of pigs, or from the lungs of cattle. The drug inhibits the transformation of fibrinogen into fibrin, and is now used for the treatment of thromboses, embolisms and for the prophylaxis of cardiac infarction and thrombosis. A disadvantage is, that heparin is not resorbed from the gastrointestinal tract, and has to be administered via an intravenous, subcutaneous or percutaneous route. 

If structural abnormalities such as vascular malformations, hypervascular tumors, vessel wall irregularities suggesting erosion etc., are visualized, then we may try for a palliative embolization with Gelfoam or particulates. Rarely, curative embolization of an arteriovenous malformation or fistula is achievable with non-resorbable agents, such as glue or detachable balloons. 

The preferred embolic agent is a material that is resorbable. The one most widely used is Gelfoam. Gelfoam can be cut into different sizes depending on the target vessel diameter. The Gelfoam can also be cut in torpedo and inserted into a 1-ml syringe. 

However, in these cases the embolization agent has usually been resorbable gelatine sponge which does not produce as distal a block as non-resorbable particles and therefore may affect the uterus differently [13,115]. Encouragingly, ultrasound and MRl observation of the uterus following embolization demonstrates rapid revascularization of the normal myometrium and an essentially normal appearance of the endometrium on 3- to 6-month MRI exami-... 

Resorbable calibrated microspheres with controlled resorption time could be advantageously proposed for uterine fibroid embolization. Theoretically, such a product could better guarantee that uterine artery and branches recover a complete functionality after embolization than non-resorb-able particles. 

There are also issues with frequent recanalization of treated vessels because the gel is resorbable, and as such, the gel may be fully resorbed before stable fibrosis occurs. Gelfoam use is often combined with embolic coils so that the gel creates the initial occlusion and the coils are implanted to retain the clot at the treatment region after the body begins resorbing the gelatin (Lubarsky et al., 2009 Vaidya et al., 2008). 

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