Endovascular coil embolization compared to surgical ligation of the uterine artery in a non-human primate model in a model of preeclampsia

BACKGROUND: Preeclampsia is a multisystem pregnancy disorder that is a major contributor to maternal and neonatal morbidity and mortality worldwide. An animal model facilitates further understanding of the disorder and allows for the investigation of targeted therapies prior to first in-human studies. Although there are several animal models for studying preeclampsia, the utero-placental ischemia (UPI) model is thought to best replicate the placental ischemia that develops as preeclampsia evolves in humans. An established non-human primate (NHP) model of UPI resembles human preeclampsia and has been important in understanding and finding cures for this disorder. To date the ischemia in most animal models has been undertaken by surgical ligation of a uterine artery. There are however alternate means to reduce arterial blood flow via endovascular means. This study aimed to investigate the difference between the surgical reduction in flow (surgical UPI) to the use of percutaneously delivered intra-arterial coils (coils UPI). RESULTS: There was no significant difference between the two methods of inducing UPI for the measured parameters: circulating soluble fms-like tyrosine kinase-1(sFLT-1), blood pressure (BP) and proteinuria (p < 0.05). The results showed a percentage change from baseline in sFLT-1 of 3176 ± 1558% for the embolization and 2040 ± 1645% for the ligation group p = 0.11, three days post-UPI induction. Moreover, there was no difference between the two models in terms of preeclampsia-defining features. CONCLUSIONS: No statistically significant difference was found between the two methods, coils for endovascular embolization and surgical UPI. However, since endovascular embolization is a less invasive technique compared to ligation it may be preferred for induction of UPI in the NHP model.