Selective Arterial Embolization Research Articles

Percutaneous treatments of primary aneurysmal bone cysts: systematic review and meta-analysis.

To systematically review the literature to determine recurrence rates of percutaneous treatments for primary aneurysmal bone cysts (ABC). Search strategies were performed in the following databases: PubMed, SCIELO, LILACS and BVS, using terms in English, Spanish and Portuguese (PROSPERO Registration Number: CRD42020170340). Longitudinal studies, either observational or clinical trials, with at least five patients and with a mean of 18months of follow-up were included. Studies had to use any type of percutaneous treatments and report the recurrence rates of primary ABC treatment. Studies selection, data extraction and risk of bias assessment were performed independently by two researchers. A global meta-analysis was carried out to assess the proportion of recurrence. Studies were categorized into two subgroups: selective arterial embolization and sclerotherapy. Thirteen studies were included in the present study. The average success rate of percutaneous treatments for ABC was 91.11%, with a total of 37 lesions recurrences in the 416 patients. The sex ratio was 1:1. The subgroup of sclerotherapies presented a lower proportion of recurrence. The proportion of recurrence in the subgroup of selective arterial embolization was 19% (95%IC 12.11-27.54) and that of sclerotherapies was 6% (95%IC 3.65-9.19). Both percutaneous treatments for ABC are effective, showing a lower rate of recurrence. Sclerotherapy treatments seem to be promising, but further clinical trials must be conducted with a longer follow-up.

Clinical factors that influence the occurrence of symptomatic pseudoaneurysms and arteriovenous fistulas after partial nephrectomy: multi-institutional study of renal function outcomes after one year of selective arterial embolization.

ABSTRACTPurpose:Renal artery pseudoaneurysms (RAPs) and arteriovenous fistulas (AVFs) are rare but potentially life-threatening complications after partial nephrectomy (PN). Selective arterial embolization (SAE) is an effective method for controlling RAPs/AVFs. We assessed the clinical factors affecting the occurrence of RAPs/AVFs after PN and the effects of SAE on postsurgical renal function.Materials and Methods:Four hundred ninety-three patients who underwent PN were retrospectively reviewed. They were placed in either the SAE or the non-SAE group. The effects of clinical factors, including R.E.N.A.L. scores, on the occurrence of RAPs/AVFs were analyzed. The influence of SAE on the estimated glomerular filtration rate (eGFR) during the first postoperative year was evaluated.Results:Thirty-three (6.7%) patients experienced RAPs/AVFs within 8 days of the median interval between PN and SAE. The SAE group had significantly higher R.E.N.A.L. scores, higher N component scores, and higher L component scores (all, p <0.05). In the multivariate analysis, higher N component scores were associated with the occurrence of RAPs/AVFs (Odds ratio: 1.96, p=0.039). In the SAE group, the mean 3-day postembolization eGFR was significantly lower than the mean 3-day postoperative eGFR (p <0.01). This difference in the eGFRs was still present 1 year later.Conclusions:Renal tumors located near the renal sinus and collecting system were associated with a higher risk for RAPs/AVFs after PN. Although SAE was an effective method for controlling symptomatic RAPs/AVFs after PN, a procedure-related impairment of renal function after SAE could occur and still be present at the end of the first postoperative year.

Musculoskeletal Interventional Radiology in the Pediatric Population: State of the Art.

Interventional radiology procedures have been proven to be as effective as traditional surgery but usually are characterized by lower morbidity rates. In this article, the most diffuse IR treatments for pediatric lesions are reviewed with the aim of describing main advantages and drawbacks. Ablation procedures (in particular RFA and MRgFUS) are widely used for the management of osteoid osteoma and osteoblastoma whereas intracystic injection of methylprednisolone acetate is performed for simple bone cysts. Sclerosing agents and where possible, selective arterial embolization are used for treatment of aneurysmal bone cysts and other vascular malformations. In the management of malignant muscoloskeletal tumors, the role interventional radiology is mainly represented by percutaneous biopsies, and by adiuvant selective embolizations in presence of hypervascular lesions to be submitted to surgery.

Spectrum of vascular complications in acute pancreatitis - challenges in management

Background: Vascular complication of pancreatitis is a rare entity. Due to its rarity, the diagnostic and therapeutic strategy for the management of this potentially life threatening problem remains undefined. The objective of our study is to highlight the spectrum of manifestations, challenges in the diagnosis and management of vascular complications of acute pancreatitis. Methods: Patients who were managed for vascular complication of acute / chronic pancreatitis were retrospectively analysed from the year 2000 to 2019. Results: There were a total of 79 patients ( 71 Male:8 Female) with a mean age of 34.8 years . 27 patients had chronic alcoholic pancreatitis 27- Tropical pancreatitis , 18- acute pancreatitis , 3- idiopathic and 1 had post traumatic pancreatitis. 8 patients were managed conservatively. Selective arterial embolization was attempted in 55 of 70 (78.5%) patients and was successful in 44 of the 55 (80 %). 27 of 76 (31.5%) patients required surgery. Overall mortality was 7.8 %. Conclusion: Upper gastrointestinal bleeding in a patient with a history of chronic pancreatitis could be caused by HP. All hemodynamically stable patients with HP should undergo prompt initial angiographic evaluation, and if possible, embolization. Hemodynamically unstable patients and those following unsuccessful embolization should undergo emergency haemostatic surgery. Centralization of GI bleed services along with a multidisciplinary team approach and a well-defined management protocol is essential to reduce the mortality and morbidity of this condition.Tabled 1Table showing the statistics of the patient managed

Prophylactic interventional radiological procedures in postpartum hemorrhage: The present scenario

Postpartum hemorrhage (PPH) is the leading cause of preventable maternal mortality and morbidity. Women undergoing cesarean delivery are at increased risk of PPH as compared to vaginal delivery. Improvement in obstetric care and advances in diagnostic modalities have empowered obstetricians to detect, predict, and therefore prevent catastrophic uterine bleeding. Patients at increased risk for PPH should be referred to tertiary care centers equipped with interventional radiology suite, where multidisciplinary teams are available 24 h and are prepared to deal with potential complications. This review highlights the management of PPH with special emphasis on interventional radiology procedures for the prevention of PPH. Minimally invasive interventional radiological techniques such as selective arterial embolization and arterial balloon occlusion have been effectively used to avert hysterectomy and reduce the overall incidence of blood transfusion and its associated complications while preserving reproductive functions.

Bilateral uterine artery embolization for the management of bilateral uterine artery pseudoaneurysm during puerperium: A case report

Background: Uterine artery Pseudoaneurysm is a rare cause of secondary postpartum hemorrhage (PPH) and can develop after various gynecological or obstetric procedures. The delayed diagnosis of such cases often results in life threatening situations. We report a rare case of bilateral uterine artery pseudoaneurysm that led to life threatening secondary PPH after Caesarean section in a patient who had several Caesarean sections before. Case description: A 35 years old multiparus women, who had all her four deliveries by Caesarean sections, presented with recurrent massive attacks of secondary PPH 35ays after her last delivery. Rupture of aneurysm of the uterine artery was suspected and CT angiography showed that the left uterine artery seemed more dilated and was probably the source of the PPH. The bleeding site was successfully tackled by selective arterial embolization. About three weeks later the patient presented again with severe recurrence of PPH. Repeat of CT angiography showed that the source was the right uterine artery this time, which was again selectively embolized. No further bleeding events occurred up to two years follow-up. Conclusion: Rupture of aneurysm of the uterine artery can be a life-threatening condition. Clinical suspicion is essential for a prompt diagnosis Definitive diagnosis can be achieved by CT-angiography. Treatment by selective embolization can effectively stop the bleeding.

Safety and efficacy of prostatic artery embolization for large benign prostatic hyperplasia in elderly patients.

ObjectiveTo assess the safety and efficacy of prostatic arterial embolization (PAE) for elderly patients with lower urinary tract symptoms secondary to large benign prostatic hyperplasia.MethodsTwenty-eight patients (>80 years of age) with prostate volume >80 mL were enrolled from October 2016 to October 2019. PAE was performed using microspheres and functional results were evaluated at 1, 3, 6, and 12 months postoperatively. The following data were recorded: International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urine flow rate (Qmax), post-void residual urine volume, prostate volume and total prostate-specific antigen level.ResultsSelective prostatic arterial catheterization and embolization were achieved in 27 of 28 patients. Follow-up data were available for those 27 patients until 12 months postoperatively. Significant improvements were found at all postoperative time points in terms of the mean IPSS, mean QoL score, mean Qmax, mean post-void residual urine volume, mean total prostate-specific antigen level, and mean prostate volume. The overall complication rate was 46.4%.ConclusionsPAE is an efficacious and safe treatment for elderly patients with large prostate volume; it may offer an effective approach for patients who are not candidates for open or endoscopic surgical procedures because of comorbidities.

The spectrum of blunt abdominal trauma in Pietermaritzburg

ABSTRACT BACKGROUND: This study reviews the Pietermaritzburg Metropolitan Trauma Service (PMTS) experience with the management of blunt abdominal trauma (BAT METHODS: A retrospective review of the hybrid electronic medical registry (HEMR) between December 2012 and September 2019 was conducted. All patients admitted following BAT were included RESULTS: During the study period, 1 123 BAT patients were managed by the PMTS. The mean age was 29.19 years (SD 14.03). Of these admissions, 73.6% were male. The most common mechanism was road traffic crashes (RTCs) - 435 motor vehicle collisions (MVCs) and 250 pedestrian vehicle collisions (PVCs). There were 186 assaults, 118 falls, 62 community assaults, 22 accidents related to agriculture, construction or industry, 11 sporting injuries, nine animal injuries, seven patients injured by falling objects, five injured by trains, two hangings, one burn-related fall and two other causes. The mechanism of injury was unknown in 22 cases. There were 445 abdominal CT scans and 270 whole body CT scans. Surgical management was required for 395 patients. There were 259 index laparotomies and 176 repeat laparotomies. Four patients underwent selective arterial embolisation. Laparoscopy was undertaken in ten, and subsequently converted to laparotomy in five. There were 106 orthopaedic operations. Hospital stay ranged from 0-155 days (median stay three days). ICU admission was required in 24.9% of patients. The mortality rate was 7.5% CONCLUSION: BAT is common in South Africa. Whilst the vast majority of patients require non-operative treatment, a well-defined subset require a laparotomy. Imaging is central to the management of patients with BAT Keywords: blunt abdominal trauma, hybrid electronic medical registry

A rare case of huge aneurysmal bone cyst of the pelvis

A 21-year-old female presented with a huge painful aneurysmal bone cyst (ABC) involving the left ilium, acetabulum, and ischium, resulting in a limp and activity limitation. After serial selective arterial embolization, intravenous bisphosphonates, and surgical curettage with bone grafting and cementing, she could achieve painless, nearly full range of motion at 2-year and 3-month follow-up with no recurrence. Her quality of life using the RAND 36-item Health Survey (version 1.0), the Musculoskeletal Tumor Society Scoring System (MSTS), and the Toronto Extremity Salvage Score indicated a good outcome. The aim of reporting this case was to show that it is safe to surgically approach a large pelvic ABC after devascularization with scleroembolic procedures augmented with intravenous bisphosphonates.

Lower Gastrointestinal Bleeding Treated with Super Selective Arterial Embolization: A Case Report

Lower Gastrointestinal Bleeding Treated with Super Selective Arterial Embolization: A Case Report

Selective embolization of lingual artery in transoral robotic surgery for the management of recurrent base of tongue carcinomas

The incidence of oropharyngeal carcinoma has been on the rise in recent decades. About 30% of patients who undergo definitive chemoradiation as the initial treatment present with residual/recurrent disease. In such a situation, surgical salvage either in the form of traditional open surgery or transoral robotic surgery (TORS) remains a viable treatment option. However, the extensive vascular supply of the posterior tongue and tonsillar bed increases the risk of perioperative bleeding, which is a key concern. The article describes the technique of selective pre-operative embolization to reduce the risk of perioperative bleeding and enumerate its advantages in providing a bloodless field during surgery. Prospective study of 5 patients with recurrent or residual midline BOT tumours who underwent TORS after selective lingual artery embolization at our centre. None of the patients had any major perioperative bleeding or post procedural complications. All the patients after TORS had their tongue vascularity preserved with adequate recovery of tongue functions. Selective embolization of the feeder vessels provides a favorable bloodless surgical field without affecting the vascular integrity of the remnant tongue. This added advantage helps restoring the normal oral phase of swallowing.

Transfemoral embolization of a large symptomatic renal angiomyolipoma in a horseshoe kidney: a case report and literature review

Renal angiomyolipomas (AML) are the commonest benign renal neoplasms. They are composed of blood vessels, adipose tissue, and smooth muscle in varying amounts. It is quite rare to find AML in a horseshoe kidney, although there is at least one such reported case discovered in pregnancy and managed by resection. Spontaneous hemorrhage which could be fatal is the most feared sequelae of AML. The first-line of management for AMLs was previously surgical excision. However, advances in minimally invasive techniques that have a lower risk of complications have broadened treatment options for reducing tumour size and preventing hemorrhage. One of such effective techniques is selective arterial embolization (SAE) of renal AMLs &gt; 4cm. Patients not requiring any immediate intervention maybe followed up with active surveillance. In this case report, we present a case of AML in a horseshoe kidney that was successfully treated with transfemoral embolization as well as a review of the literature.

Surgical Strategy of Pediatric Benign Sacral Tumors

Background: Primary benign osseous tumors and tumor-like lesions at the sacrum are rare in the pediatric population and exact surgical strategy is still unclear. In this study, we evaluate the outcome for pediatric patients with benign tumors and tumor-like lesions at the sacrum who were receiving surgical treatment according to our proposed surgical strategy and classification. Methods: We analyzed 49 pediatric patients with sacral benign tumors or tumor-like lesions aged 18 years and below from 2005 to 2018. There were 23 men and 26 women with a mean age of 14.0±3.8 years. Nineteen patients had giant cell tumors (GCTs), 9 aneurysmal bone cysts, 5 osteoblastomas, 5 neurogenic tumors, 3 hemangiomas, 3 teratomas, 2 Langerhans cell histiocytosis, 1 chondroblastoma, 1 fibrous dysplasia, and 1 GCT of tendon sheath. We proposed our surgical plan and surgical classification for pediatric patients with sacral benign tumors or tumor-like lesions. Results: The mean follow-up duration was 6.2 years (range, 1.0 to 18.9 y). GCTs (39%, 19/49) and primary aneurysmal bone cysts (18%, 9/49) are the top 2 common histologic types. Preoperative selective arterial embolization (SAE) was performed in 12 cases and 24 patients received intraoperative aortic balloon occlusion (ABO) as the preoperative surgical plan. Furthermore, according to tumor location at the sacrum, we classified surgical excision of sacral benign tumors and tumor-like lesions into 3 types. Fourteen cases were classified as type I, 27 as type II, 3 as type III, and 5 patients with neurogenic tumors cannot be classified into this surgical classification. Ten patients had wound complications. Two had femoral artery thrombosis because of ABO application. One had mechanical failure. Rate of local recurrence was 16%. Seven patients with GCTs and 1 with neurogenic tumor had local recurrence. No patient died of disease at the last follow-up. For the assessment of neurological function, the rate of neurological dysfunction was 12% (6/49). Four cases had urinary incontinence, 3 fecal incontinence, and 3 had bowel obstruction. Next, univariate analysis for influence of preoperative SAE and intraoperative ABO on complications demonstrated that both of them exerted no significant influence on the occurrence of oncological and nononcological complications. Conclusions: The proposed surgical strategy can provide an excellent therapeutic effect for pediatric benign tumors and tumor-like lesions at the sacrum. Preoperative SAE and intraoperative ABO can safeguard pediatric patients with high vascularity of benign tumor at the sacrum during the operation. Level of Evidence: Level IV.

Long-term results of super-selective trans-catheter embolization of the vesical arteries for the treatment of intractable bladder haematuria

PurposeTo evaluate the feasibility, safety and long-term efficacy of super-selective trans-catheter arterial embolization for the management of intractable bladder bleeding.Materials and methodsThe records of 20 patients with intractable haematuria referred urgently for selective arterial embolization after failed conventional therapy, between 2013 and 2018, were retrospectively analyzed. Primary outcomes were technical (cessation of extravasation and/or stasis of flow within the target vessel) and clinical (bleeding control) success. Secondary outcomes included complication and re-intervention rates.ResultsTechnical success was 90% (18/20 cases), as in 2 cases, embolization was not feasible. Super-selective embolization of the vesical arteries was feasible in 15/18 cases (83.3%). Selective proximal occlusion of the anterior division of the internal iliac artery was performed in two cases (11%) and embolization of the anterior division after coil blockage of the posterior division was performed in one case (5%). Bilateral and unilateral embolization was performed in 10 and 8 cases, respectively. Peri-procedural mortality rate was 5% (1/18 patients). One possible procedure-related death occurred due to myocardial infarction ten days following non-target embolization of the buttocks and the anterior abdominal wall. Mean time follow up was 35 ± 15 months. Bleeding reoccurred in three patients (16.6%), all successfully managed (one conservatively and two with further embolization). Clinical success was 85% (17/20 cases). During follow up 11 more patients died, due to underlying conditions not related to bleeding or the procedure.ConclusionsSuper-selective angiographic embolization is feasible, safe and effective to control refractory, life threatening bladder bleeding and should be considered as a first line treatment, as to obviate the need for emergency surgery.

Efficacy of prophylactic selective arterial embolization for renal angiomyolipomas: identifying predictors of 50% volume reduction

BackgroundTranscatheter arterial embolization (TAE) has been widely performed for renal angiomyolipomas (AMLs) as prophylaxis or emergency treatment. On the other hand, mammalian target of rapamycin (mTOR) inhibitors have recently been used for tuberous sclerosis (TSC)-related AMLs, and no comparison between the effectiveness of mTOR inhibitors versus prophylactic selective TAE has yet been performed.Therefore, the purpose of this study was to evaluate the efficacy of TAE for AML tumor volume reduction and predictors of tumor volume decrease over 50%, with reference to the EXIST-2 trial.MethodsA total of 44 patients who underwent 48 prophylactic embolization procedures for 50 AMLs in a single institution between 2004 and 2018 were included. Indications for TAE of AMLs were tumor size ≥4 cm or aneurysm ≥5 mm in diameter on contrast-enhanced computed tomography (CECT). Microspheres, ethanol, and micro-coils were used as embolic agents. The percentage volume reduction from before TAE to the minimum volume during follow-up after TAE was calculated, and predictors for 50% volume reduction were identified by univariate and multivariate binary logistic regression analyses.ResultsThe technical success rate was 100% (50 of 50). No severe acute complications related to the procedure were encountered. Tumor volume reduction of ≥50% was observed in 35/50 AMLs. There was a significant difference in the rate of tumor volume reduction of 50% between the presence and absence of an aneurysm ≥5 mm and between tumor diameter ≥ 70 mm and < 70 mm on univariate analysis. On multivariate analysis, tumor diameter < 70 mm was the only independent predictor of significant tumor volume reduction after TAE.ConclusionProphylactic selective TAE for AMLs has good tumor-reduction effects, especially for AMLs with tumor diameter < 70 mm.

Primary aneurysmal bone cyst of sacrum for adolescent: Eleven cases experience and literature review

The present study is aiming to describe clinical characteristics, surgical flowchart and treatment results of eleven adolescent patients with primary aneurysmal bone cyst (ABC) of sacrum and review in the literature. We retrospectively reviewed eleven young patients with sacral primary ABC, which had the intact clinical and follow-up information at our bone tumor center from 2001 to 2018. The literature review was based on Google Scholar, Medline, EMBASE and Pubmed databases. The search was performed using terms of “aneurysmal bone cyst”, “sacral tumor”, “sacrum tumor” “spine tumor” and “spinal tumor” for the literature review from 1998 to 2019. There were six male and five female with a mean age of 13 years old at the presentation. The mean follow-up duration was 6.5 years. No patient died of disease and had the pulmonary metastasis. Two patients had wound complications, including onesurgical site infection and one wound dehiscence. No patient had the local recurrence and neurologic deficit. In the literature review, 11 articles were reviewed and 45 cases with sacral primary ABC were included. The rate of local recurrence may be higher than that in our cohort. We proposed our flow chart for preparation of surgery for patients. Preoperative selective arterial embolization and intraoperative aortic balloon occlusion could provide the clear surgical vision and guarantee complete tumor excision by intralesional curettage. Preoperative selective arterial embolization, intraoperative aortic balloon occlusion and complete tumor excision by intralesional curettage can yield satisfactory results with a low rate of recurrence in adolescent patients with a sacral primary ABC.

Spontaneous rupture of enormous renal angiomyolipoma in a pregnant tuberous sclerosis patient: a rare case

BackgroundRenal angiomyolipoma (RAML) is a rare benign kidney tumour comprised of adipose tissue, smooth muscle, and blood vessels. It can cause fatal complications if it ruptures. Although there have been reports of RAMLs rupturing, it is unusual to see RAMLs rupture during pregnancy, especially in pregnant women with tuberous sclerosis (TSC). Moreover, we reported a rare complication after selective arterial embolization (SAE) for the first time, which called aseptic liquefaction necrosis.Case presentationThe case is a 16-week-pregnant woman with TSC who presented with severe flank pain, which was secondary to the rupture of a large, previously unknown RAML. This was confirmed by emergency computed tomography and successfully treated with selective arterial embolization after the patient received counselling and provided prior informed written consent for medical termination of pregnancy (MTP). The patient underwent abortion 3 weeks after the SAE. The patient required drainage 2 months after the SAE because of aseptic liquefaction necrosis. During follow-up, the patient’s lesion remained stable.ConclusionRAML rupture is a rare but rather serious complication in pregnant tuberous sclerosis patients. Selective arterial embolization (SAE) should be performed immediately, and the status of the pregnancy needs to be assessed by a multidisciplinary team. We also report for the first time the rare complication of aseptic liquefaction necrosis after SAE of RAML, for which percutaneous drainage is effective.

Successful laparoscopic surgery combined with selective arterial embolization for bleeding due to jejunal angiodysplasia: a case report

BackgroundAngiodysplasia of the gastrointestinal tract is a rare vascular pathology that sometimes causes massive hemorrhage. Angiodysplasias are particularly difficult to find in the small intestine for anatomical reasons, often impeding their diagnosis and treatment. Lesion localization is a major challenge in cases of small bowel bleeding requiring surgical intervention.Case presentationThe present case was a 52-year-old woman who was urgently hospitalized with repeated tarry stools. Surgical intervention was chosen after conservative treatment failed to improve her condition. The source of bleeding was suspected to be a vascular lesion discovered in the small intestine during a past double-balloon endoscopy. Abdominal contrast computed tomography revealed a jejunal hemorrhage. We chose selective arterial embolization to stabilize her hemodynamics followed by surgical intervention as her treatment plan. Several embolic and contrast agents (cyanoacrylate, indigo carmine, and Lipiodol) were combined to help identify the location of the lesion during surgery. This multi-pronged approach allowed us to localize the lesion under laparoscopic guidance with high confidence and accuracy, and to excise a 6-cm segment of the small intestine. The lesion was histologically diagnosed as angiodysplasia. No re-bleeding has been observed since the operation.ConclusionWe report our experience with a case of jejunal angiodysplasia, which was localized with selective arterial embolization using an array of embolic and contrast agents, and then excised laparoscopically. Selective arterial embolization with indigo carmine dye to treat small bowel bleeding preoperatively not only makes the surgery safer by stabilizing the patient’s hemodynamics, but is also very useful for localizing the lesion intraoperatively.

Repeated selective arterial embolization without surgical resection in the management of a giant sporadic renal angiomyolipoma in a female patient of childbearing age – A Case Report

Angiomyolipomas (AML) are the commonest benign renal tumors. Most are small and found incidentally, but some can reach sizes of >20cm (giant AMLs).

Combined Minimally Invasive Approach to Preserving Fertility in Patients with Cervical Pregnancy

Study Objective Assess the feasibility of the minimally invasive methods in preserving the fertility in patients with cervical pregnancy. Design Canadian Task Force: Level II-2 Prospective and retrospective analysis. Setting Department of Operative Gynecology, V.I Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation; Moscow, Russian Federation. Patients or Participants 66 women with cervical pregnancies desiring preservation of fertility (ages 25-44 years), treated at the Department of Operative Gynecology during the past 13 years. Interventions Standard diagnostic clinical protocol was carried out in all patients. Patients with cervical pregnancy received intravenous methotrexate at an average of 50 mg/every 48 hours and 6 mg of intramuscular leucovorin rescue injection at 28 hours after methotrexate administration followed by resectoscopy or combined selective uterine embolization and resectoscopic approach. 2 women with massive bleeding on admission required hysterectomy. Measurements and Main Results The gestational age on admission ranged from 5 to 11 weeks with mean gestational age being 6.8 ± 0.8 weeks. 64 women underwent combined therapy with preoperative systemic methotrexate and resectoscopic excision. 28 of these patients had chorionic invasion into the cervix and required selective uterine artery embolization (SUAE), followed by resectoscopy. 2 patients with massive bleeding underwent emergent hysterectomy. Uterus preserving surgical procedures were started when a decreasing levels of β-hCG of 4000-7000I U/l were demonstrated. Bilateral SUAE was utilized in 28 cases, through the right femoral approach (12 cases) and through the right radial artery (16). The blood loss in all cases was less than 25 cc, including the ones with chorionic invasion. Conclusion The results of our study suggest that resectoscopic removal of embryos with previous cytostatic therapy with methotrexate allows for the preservation of fertility in young women with early cervical pregnancy. SUAE provides minimal operative blood loss and shorter hospital stay, and preserves reproductive potential in women with chorionic cervical invasion.