1.Superselective uterine arterial infusion and embolization in the treatment of ectopic pregnancies of 56 cases
Chaolin HAN ; Feng LIU ; Changfu LI ; Yafang GUAN ; Zhen LIU ; Weibo WANG ; Haijuan NIU ; Yanhua ZHANG
Chinese Journal of Radiology 2008;42(8):817-820
Objective To probe a simple, safe, and minimally invnsive method to treat ectopic pregnancy with preservation of the organs. Methods Superselective catheterization of uterine artery through cannulation of right femoral artery was achieved in 56 patients with ectopic pregnancy. Location of the lesions involved, feeding arteries, and active bleeding were observed on angiography. 150 mg of methylamine neopterin diluted in 100 ml of saline water was infused slowly into the target artery. Small gelatin spongy particles with size of 0.5 mm in diameter were used to embelize the uterine artery until its branches were totally obliterated. Follow-up was undertaken to observe the results of the treatment. Results Suporselective uterine arterial infusion and embolization were successfully performed in all 56 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 two days after the procedure. Beta-HCG value dropped to below 5 U/L within two to twelve days. Hemorrhage in the peritoneum dissolved after seven days in all cases. Mixed mass disappeared after one month. Histerosalpingography was performed three months after the procedure in 19 patients and patent fallopians were demonstrated in 11 patients. Conclusions Superselective uterine arterial infusion and embolization is a minimally invasive procedure, which can be used to effectively treat ectopic pregnancy by disabling the ectopic embryo and embelizing leaking arteries with the advantages of preserving the fallopian tubes.