FairEmbo Concept for Postpartum Hemorrhage: Evaluation of the Efficacy of Suture Fragment Compared with Gelatin Sponge Torpedo Embolization in a Post-Gravid Swine Model

doi:10.3390/jpm13010124

. 2023 Jan 7;13(1):124.

doi: 10.3390/jpm13010124.

FairEmbo Concept for Postpartum Hemorrhage: Evaluation of the Efficacy of Suture Fragment Compared with Gelatin Sponge Torpedo Embolization in a Post-Gravid Swine Model

Amandine Banata Gang-Ny¹, Julien Panneau^{1

2

3}, Pauline Brige^{2

3}, Jean-François Hak^{1

2

3}, Paul Habert^{1

2

3}, Vincent Vidal^{1

2

3}, Farouk Tradi^{1

2

3}, Mathieu Di Bisceglie^{1

2

3}

Affiliations

¹ Department of Interventional Imaging, Assistance Publique Hopitaux de Marseille, 13005 Marseille, France.
² LIIE, Aix Marseille University, Timone Campus, 13005 Marseille, France.
³ CERIMED, Aix Marseille University, Timone Campus, 13005 Marseille, France.

PMID: 36675785
PMCID: PMC9866904
DOI: 10.3390/jpm13010124

FairEmbo Concept for Postpartum Hemorrhage: Evaluation of the Efficacy of Suture Fragment Compared with Gelatin Sponge Torpedo Embolization in a Post-Gravid Swine Model

Amandine Banata Gang-Ny et al. J Pers Med. 2023.

. 2023 Jan 7;13(1):124.

doi: 10.3390/jpm13010124.

Authors

Affiliations

¹ Department of Interventional Imaging, Assistance Publique Hopitaux de Marseille, 13005 Marseille, France.
² LIIE, Aix Marseille University, Timone Campus, 13005 Marseille, France.
³ CERIMED, Aix Marseille University, Timone Campus, 13005 Marseille, France.

PMID: 36675785
PMCID: PMC9866904
DOI: 10.3390/jpm13010124

Abstract

Background: Postpartum hemorrhage is the leading cause of maternal mortality in emerging countries. This study aims to evaluate the effectiveness and safety of uterine artery embolization (UAE) using suture fragment (FairEmbo concept) in a swine model.

Methods: Seven female swine uteri were embolized. The left uterine artery was embolized with 1 cm fragments of absorbable suture (Optime^® 0), and with gelatin sponge torpedoes for the contralateral side for comparison. The embolization effectiveness and the time for arterial recanalization with digital subtraction angiography (DSA) controls at D0, D7, and M1, were evaluated. Follow-up protocol also included clinical monitoring and macroscopical analyses at M1. A Mann-Whitney test (significance at P 0.05) was used for statistics.

Results: A technical success was obtained for the seven arteries on each side, with no off-target embolization. The procedure time (10 min versus 3.7 min) and number of fragments (13.8 versus 5.7) required for complete occlusion were significantly greater in the FairEmbo group. All arteries were repermeabilized at M1. No necrosis was macroscopically visible at harvest at M1.

Conclusion: This experimental study suggests that UAE with SBM FairEmbo method is feasible, safe, and effective in comparison with gelatin sponge procedure.

Keywords: FairEmbo; gelatin sponge; postpartum hemorrhage; suture; uterine artery embolization (UAE).

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Comparison between a 1 cm long Optime 0 suture fragment (A) and a gelatin torpedo as usually shaped (B).

**Figure 2**
Angiography controls before uterine embolization (A,B), just after arterial embolization (right side by gelatin torpedo (C), left side by suture fragment (D)), and at one month after embolization (E,F). The DSA controls showed effective embolization on both sides, and complete recanalization at 1 month after embolization.

**Figure 3**
Uterus harvested. The right side was embolized with gelatin torpedoes, the left side was embolized with suture fragments. There was no difference in mucosal staining between the two sides, including no evidence of necrosis.

See this image and copyright information in PMC

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[1] McLintock C., James A.H. Obstetric hemorrhage. J. Thromb. Haemost. 2011;9:1441–1451. doi: 10.1111/j.1538-7836.2011.04398.x. - DOI - PubMed

[2] McLintock C., James A.H. Obstetric hemorrhage. J. Thromb. Haemost. 2011;9:1441–1451. doi: 10.1111/j.1538-7836.2011.04398.x. - DOI - PubMed

[3] Mercier F.J., Van de Velde M. Major obstetric hemorrhage. Anesthesiol. Clin. 2008;26:53–66. doi: 10.1016/j.anclin.2007.11.008. - DOI - PubMed

[4] Mercier F.J., Van de Velde M. Major obstetric hemorrhage. Anesthesiol. Clin. 2008;26:53–66. doi: 10.1016/j.anclin.2007.11.008. - DOI - PubMed

[5] Say L., Chou D., Gemmill A., Tunçalp Ö., Moller A.B., Daniels J., Gülmezoglu A.M., Temmerman M., Alkema L. Global causes of maternal death: A WHO systematic analysis. Lancet Glob. Health. 2014;2:e323–e333. doi: 10.1016/S2214-109X(14)70227-X. - DOI - PubMed

[6] Say L., Chou D., Gemmill A., Tunçalp Ö., Moller A.B., Daniels J., Gülmezoglu A.M., Temmerman M., Alkema L. Global causes of maternal death: A WHO systematic analysis. Lancet Glob. Health. 2014;2:e323–e333. doi: 10.1016/S2214-109X(14)70227-X. - DOI - PubMed

[7] Ononge S., Mirembe F., Wandabwa J., Campbell O.M. Incidence and risk factors for postpartum hemorrhage in Uganda. Reprod. Health. 2016;13:38. doi: 10.1186/s12978-016-0154-8. - DOI - PMC - PubMed

[8] Ononge S., Mirembe F., Wandabwa J., Campbell O.M. Incidence and risk factors for postpartum hemorrhage in Uganda. Reprod. Health. 2016;13:38. doi: 10.1186/s12978-016-0154-8. - DOI - PMC - PubMed

[9] Guasch E., Gilsanz F. Massive obstetric hemorrhage: Current approach to management. Med. Intensiva. 2016;40:298–310. doi: 10.1016/j.medin.2016.02.010. - DOI - PubMed

[10] Guasch E., Gilsanz F. Massive obstetric hemorrhage: Current approach to management. Med. Intensiva. 2016;40:298–310. doi: 10.1016/j.medin.2016.02.010. - DOI - PubMed

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FairEmbo Concept for Postpartum Hemorrhage: Evaluation of the Efficacy of Suture Fragment Compared with Gelatin Sponge Torpedo Embolization in a Post-Gravid Swine Model

Affiliations

FairEmbo Concept for Postpartum Hemorrhage: Evaluation of the Efficacy of Suture Fragment Compared with Gelatin Sponge Torpedo Embolization in a Post-Gravid Swine Model

Authors

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Abstract

Conflict of interest statement

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Abstract

Conflict of interest statement

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