Abstract
Once fibroid ischemia is achieved by the blockade of the uterine arteries with particles, there is no longer the need for these particles which act as permanent foreign bodies in the uterus. They generate inflammation and will compromise the physiological adaptation of the uterine arteries during pregnancy. After having played their role, the particles have to disappear. The time for resorbable biomaterials has come. Promising degradable microspheres are being developed from various biomaterials such as oxidized carboxymethylcellulose combined with chitosan (OCMCC), poly(lactic-co-glycolic acid) (PLGA), saponified poly(vinyl alcohol) (PVA), poly(ethylene glycol) (PEG) hydrogel cross linked with hydrolyzable bridges. They generate more or less inflammation according to their speed of degradation. Their potential to achieve a satisfactory necrosis of the fibroids and a full artery recanalization will be discussed.
Highlights
Uterine artery embolization (UAE) consists of blocking the blood flow of uterine arteries with small particles in order to necrotize the fibroids present in uterus
In a large cohort of women wishing to conceive before embolization, that complete pregnancies can occur after UAE [1]
The particles could play a major role in post-UAE fertility disorders by themselves since they induce a durable inflammation in the uterus and impair the recovery of uterine arteries
Summary
Once fibroid ischemia is achieved by the blockade of the uterine arteries with particles, there is no longer the need for these particles which act as permanent foreign bodies in the uterus They generate inflammation and will compromise the physiological adaptation of the uterine arteries during pregnancy. Promising degradable microspheres are being developed from various biomaterials such as oxidized carboxymethylcellulose combined with chitosan (OCMCC), poly(lactic-co-glycolic acid) (PLGA), saponified poly(vinyl alcohol) (PVA), poly(ethylene glycol) (PEG) hydrogel cross linked with hydrolyzable bridges. They generate more or less inflammation according to their speed of degradation. Their potential to achieve a satisfactory necrosis of the fibroids and a full artery recanalization will be discussed
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