Recanalization and particle exclusion after embolization of uterine arteries in sheep: a long-term study  Alexandre Laurent, M.D., Ph.D., Michel Wassef, M.D., Julien Namur, Ph.D., Jacques Martal, Vet. D. Ph.D., Denis Labarre, Ph.D., Jean- Pierre Pelage, M.D., Ph.D.  Fertility and Sterility  Volume 91, Issue 3, Pages 884-892 (March 2009) DOI: 10.1016/j.fertnstert.2007.12.015 Copyright © 2009 American Society for Reproductive Medicine Terms and Conditions

Figure 1 Example of orcein stains. (a) Several PVA particles (in black) are embedded in a fibrotic cushion located in the intima. The internal elastic limitans (IEL) presents some ruptures (arrows). A lumen containing red blood cells is visible (star). EEL = external elastic limitans. (b) One TGMS is visible outside of the vessel. The internal and external elastic limitans are broken close to the microsphere (arrowheads), confirming its transvascular migration. Fertility and Sterility 2009 91, 884-892DOI: (10.1016/j.fertnstert.2007.12.015) Copyright © 2009 American Society for Reproductive Medicine Terms and Conditions

Figure 2 Partition of embolic agent in the uterine layers. TGMS and PVA were differently located in the different layers of the uterus (P<.0001, chi-square). PVA particles were located more proximally than TGMS (95.6% vs. 68% found in the trunk and first branches of the uterine artery, respectively). The embolic agents were not (PVA) or rarely (TGMS) observed in the endometrium. Fertility and Sterility 2009 91, 884-892DOI: (10.1016/j.fertnstert.2007.12.015) Copyright © 2009 American Society for Reproductive Medicine Terms and Conditions

Figure 3 Recanalization rate. For TGMS, there was no difference in TGMS size between the group with recanalization and the group with no recanalization. By contrast, the rate of recanalization was statistically significantly influenced by the size of PVA aggregates (P=.0002, Mann-Whitney): recanalization was observed with small aggregates (653 ± 440 μm), whereas no recanalization was noted with larger PVA aggregates (1026 ± 554 μm). Fertility and Sterility 2009 91, 884-892DOI: (10.1016/j.fertnstert.2007.12.015) Copyright © 2009 American Society for Reproductive Medicine Terms and Conditions

Figure 4 Location of the embolic agent (%). The location of particles within the different layers of the vessel was statistically significantly different between the two embolic agents (P<.0001, chi-square). TGMS were found in the three layers of the vessel wall; 44.8% of TGMS were located in the intima, 24.7% in the media, and 30.5% outside the vessel. PVA particles were found almost exclusively in the intima (99.2%), and nearly none (0.8%) were observed outside the vessel. Fertility and Sterility 2009 91, 884-892DOI: (10.1016/j.fertnstert.2007.12.015) Copyright © 2009 American Society for Reproductive Medicine Terms and Conditions