Mark Mikhitarian, William Goodnight Iii, Nicole Keefe
{"title":"局部甲氨蝶呤加子宫动脉栓塞治疗高风险间质异位妊娠。","authors":"Mark Mikhitarian, William Goodnight Iii, Nicole Keefe","doi":"10.1055/s-0043-1770712","DOIUrl":null,"url":null,"abstract":"<p><p>Interstitial ectopic pregnancy involves the interstitial portion of the fallopian tube and is among the most hazardous of all ectopic pregnancies, with the highest risk of uterine rupture and maternal mortality. Unlike tubal ectopic pregnancy, management of interstitial pregnancy is not well standardized. Systemic methotrexate (MTX) and surgical resection are the primary treatment options; however, failure rates and risk of bleeding remain high. Alternative minimally invasive techniques have been described-including uterine artery embolization (UAE) and local injection of MTX or potassium chloride-and may confer improved success rates. We report a case of a high-risk 28-year-old female with an interstitial ectopic pregnancy successfully treated with combined local injection of MTX plus UAE. We describe our technique and the unique medical management in the setting of a known bleeding disorder.</p>","PeriodicalId":48689,"journal":{"name":"Seminars in Interventional Radiology","volume":"40 4","pages":"357-361"},"PeriodicalIF":1.0000,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10415050/pdf/","citationCount":"0","resultStr":"{\"title\":\"Local Methotrexate Plus Uterine Artery Embolization for High-Risk Interstitial Ectopic Pregnancy.\",\"authors\":\"Mark Mikhitarian, William Goodnight Iii, Nicole Keefe\",\"doi\":\"10.1055/s-0043-1770712\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Interstitial ectopic pregnancy involves the interstitial portion of the fallopian tube and is among the most hazardous of all ectopic pregnancies, with the highest risk of uterine rupture and maternal mortality. Unlike tubal ectopic pregnancy, management of interstitial pregnancy is not well standardized. Systemic methotrexate (MTX) and surgical resection are the primary treatment options; however, failure rates and risk of bleeding remain high. Alternative minimally invasive techniques have been described-including uterine artery embolization (UAE) and local injection of MTX or potassium chloride-and may confer improved success rates. We report a case of a high-risk 28-year-old female with an interstitial ectopic pregnancy successfully treated with combined local injection of MTX plus UAE. We describe our technique and the unique medical management in the setting of a known bleeding disorder.</p>\",\"PeriodicalId\":48689,\"journal\":{\"name\":\"Seminars in Interventional Radiology\",\"volume\":\"40 4\",\"pages\":\"357-361\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2023-08-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10415050/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Seminars in Interventional Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1055/s-0043-1770712\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/8/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seminars in Interventional Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/s-0043-1770712","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/8/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Local Methotrexate Plus Uterine Artery Embolization for High-Risk Interstitial Ectopic Pregnancy.
Interstitial ectopic pregnancy involves the interstitial portion of the fallopian tube and is among the most hazardous of all ectopic pregnancies, with the highest risk of uterine rupture and maternal mortality. Unlike tubal ectopic pregnancy, management of interstitial pregnancy is not well standardized. Systemic methotrexate (MTX) and surgical resection are the primary treatment options; however, failure rates and risk of bleeding remain high. Alternative minimally invasive techniques have been described-including uterine artery embolization (UAE) and local injection of MTX or potassium chloride-and may confer improved success rates. We report a case of a high-risk 28-year-old female with an interstitial ectopic pregnancy successfully treated with combined local injection of MTX plus UAE. We describe our technique and the unique medical management in the setting of a known bleeding disorder.
期刊介绍：
Seminars in Interventional Radiology is a review journal that publishes topic-specific issues in the field of radiology and related sub-specialties.
The journal provides comprehensive coverage of areas such as cardio-vascular imaging, oncologic interventional radiology, abdominal interventional radiology, ultrasound, MRI imaging, sonography, pediatric radiology, musculoskeletal radiology, metallic stents, renal intervention, angiography, neurointerventions, and CT fluoroscopy along with other areas.
The journal''s content is suitable for both the practicing radiologist as well as residents in training.
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