Embolization of Ectopic Pregnancies: A Global Perspective and its Potential Role for Interventional Radiologists in the United States

Monday, March 31, 2025

4:45 PM – 4:50 PM CT

Location: Music City Center, 207 CD

Abstract Presenter(s)

Qian Yang, MD

Resident physician
Maimonides Medical Center, United States

Author/Co-author(s)

GP

Gunnye Pak, MD

Resident physician
Maimonides Medical Center, United States
Amit Ramjit, MD

Interventional radiology independent resident
Weill Cornell Medical Center, United States
DI

Dmitri Igonkin, MD

Chief, IR
Maimonides Medical Center, United States
GC

Gregory Carbonella, MD

Attending Physician
Maimonides Medical Center, United States

Learning Objectives:

Understand the use of transcatheter arterial embolization (TAE) in managing ectopic pregnancies globally.

Explore the role of embolization in fertility-preserving treatment of ectopic pregnancies.

Discuss the potential role of interventional radiologists (IRs) in providing embolization as adjunctive treatment for ectopic pregnancies in the United States (U.S.).

Background: Advancements in transvaginal and color Doppler ultrasound now allow earlier detection of ectopic pregnancies, enabling fertility-preserving treatments {1, 2, 3}. In the U.S., treatment typically involves methotrexate or surgery. While tubal and ovarian ectopic pregnancies often respond well to these methods, rarer forms, such as cervical, abdominal, and Cesarean scar ectopic pregnancies, pose greater risks due to their location and sometimes advanced gestational age upon diagnosis. These forms increase the risk of hemorrhage, making medical or surgical treatment alone insufficient {1, 2, 4}. Transcatheter arterial embolization (TAE), performed by interventional radiologists, is a minimally invasive technique increasingly used in countries like China, Israel, and Egypt for patients at risk of hemorrhage or ineligible for surgery {5, 6, 7, 8}. Despite its success abroad, TAE remains underutilized in the U.S., presenting an opportunity for IRs to play a larger role in gynecologic emergencies.

Clinical Findings/Procedure Details: This exhibit will highlight the global use of TAE in treating ectopic pregnancies and explore its potential role in the U.S. management landscape. TAE involves selective catheterization of uterine or abdominal/pelvic arteries, delivering embolic agents to block the blood supply to the ectopic pregnancy. This effectively controls bleeding and lowers the risk of peri- and post-treatment hemorrhage. International studies report TAE as effective, with minimal complications and high fertility preservation rates. Success rates surpass 90% when combined with methotrexate {7, 9}. The minimally invasive nature of TAE allows for faster recovery and shorter hospital stays, making it a good option for patients with surgical contraindications.

Conclusion and/or Teaching Points: Transcatheter arterial embolization is a low-risk, effective, and fertility-preserving adjunctive treatment for ectopic pregnancies. With successful outcomes in the global community, TAE could enhance gynecologic emergency care provided by IRs in the U.S.