Failla Giovanni, Libra Federica, Giurazza Francesco, Lucarelli Nicola Maria, Coniglio Giovanni, Vacirca Francesco, Santonocito Serafino Maria, Dell'Atti Cristian, Camerano Francesco, Palmucci Stefano, Niola Raffaella, Basile Antonio, Patanè Domenico
Department of Diagnostic and Interventional Radiology, Azienda Ospedaliera per l'emergenza Cannizzaro, Catania, Italy.
Department of Medical Surgical Sciences and Advanced Technologies - Radiology I Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy.
Radiol Med. 2022 Dec;127(12):1313-1321. doi: 10.1007/s11547-022-01536-y. Epub 2022 Sep 27.
To assess the role of Uterine Artery Embolization (UAE) to treat cesarean scar pregnancy (CSP) using different embolic materials, focusing on its clinical and technical success rates; the association of UAE with methotrexate (MTX) and/or dilatation & curettage (D&C) was evaluated also.
A retrospective analysis 33 patients (mean age 35 years) affected by CSP and treated with UAE from March 2012 to 2020 was performed. Dynamic levels of serum β-HCG have been collected until they decreased to normal values after procedures. For the statistical analysis the sample was divided into 2 groups: UAE versus UAE + MTX.
The gestational sac age ranged between 5 and 13 weeks (mean 7 weeks). According to operator's preference, 11 patients (33.33%) were treated with sponge injection, 2 patients (6.06%) with a combination of sponge and microsphere the remaining 20 patients (60.60%) with microspheres alone. No major complications occurred after UAE and D&C, neither side effects related to the MTX administration. Technical and clinical success rates were 97% and 85%, respectively. Mean percentage of β-HCG reduction was 90% (range - 99.92 to + 7.98%). Statistical analysis with linear regression shows a R value of 0.9624 in UAE group while a R value of 0.9440 in UAE + MTX group with statistical significance (p < 0.0001). No significative differences were found between the two groups about clinical success rate and embolic material adopted.
In this series UAE has been found to be safe and effective for the treatment of CSP.
评估子宫动脉栓塞术（UAE）使用不同栓塞材料治疗剖宫产瘢痕妊娠（CSP）的作用，重点关注其临床成功率和技术成功率；同时评估UAE与甲氨蝶呤（MTX）和/或刮宫术（D&C）联合应用的情况。
对2012年3月至2020年期间33例（平均年龄35岁）接受UAE治疗的CSP患者进行回顾性分析。收集血清β-HCG的动态水平，直至术后降至正常水平。为进行统计分析，将样本分为两组：UAE组与UAE + MTX组。
孕囊年龄在5至13周之间（平均7周）。根据操作者的偏好，11例患者（33.33%）采用海绵注射治疗，2例患者（6.06%）采用海绵和微球联合治疗，其余20例患者（60.60%）仅采用微球治疗。UAE和D&C术后未发生重大并发症，也未出现与MTX给药相关的副作用。技术成功率和临床成功率分别为97%和85%。β-HCG平均降低百分比为90%（范围为-99.92至+7.98%）。线性回归统计分析显示，UAE组的R值为0.9624，UAE + MTX组的R值为0.9440，具有统计学意义（p < 0.000）。两组在临床成功率和所采用的栓塞材料方面未发现显著差异。
在本系列研究中，已发现UAE治疗CSP安全有效。
