Clinical and experimental obstetrics & gynecology

Superselective uterine arterial embolization combined with transcatheter intra-arterial methotrexate infusion in 40 cases with fallopian tube ectopic pregnancy.

PMID 23971243


To evaluate the therapeutic results of superselective uterine artery infusion and embolization in 40 patients with fallopian tube ectopic pregnancy, and to explore the role of this minimally invasive treatment as an alternative to surgery. Superselective catheterization of uterine artery through cannulation of femoral artery was achieved in 40 patients with fallopian tube ectopic pregnancy (EP). Location of the lesions involved feeding arteries and active bleeding were observed through angiography. Methotrexate (MTX) diluted in saline water was slowly infused into the target artery. Small gelatin spongy particles were used to embolize the uterine artery until its branches were totally obliterated. Follow-up was undertaken to observe the results of the treatment. Superselective uterine arterial infusion and embolization were successfully performed in all 40 patients without any related complications. Active bleeding in the peritoneum in 33 cases ceased soon after embolization. The embryos in 13 patients were confirmed to have died by ultrasound three days after the procedure. Beta-human chorionic gonadotropin ((beta-hCG) value dropped to below 15 IU/L at three to 21 days. Hemorrhage in the peritoneum dissolved after seven days in all cases. Mixed mass disappeared after one month. Hysterosalpingography was performed three months after the procedure in 19 patients and patent fallopians were demonstrated in 16 patients. Superselective uterine arterial infusion and emboliztion is a minimally invasive procedure, which can be used to effectively treat EP by disabling the ectopic embryo and leaking arteries with the advantages of preserving the fallopian tubes.