Embolization

Overview

Embolization is a minimally invasive technique that shuts or blocks a particular blood vessel. It frequently involves a planned (elective) surgery. There are some emergency situations that require immediate action.

Embolization stops blood flow by using very small particles or items known as embolic agents. The agents are administered by your healthcare practitioner via long, thin tubes called catheters. A skin incision is made to introduce the catheter, which then follows the course of the blood vessel to access the treatment site. Specialized instruments located at the catheter’s tip enable the execution of the procedure.

This kind of procedure is carried out by an interventional radiologist. The blood vessels in your body are navigated by this medical expert using catheters and real-time imaging.

Types of embolization

• Particle embolization. Reduces or stops the flow of blood to benign tumors.
• Stent-assisted coiling for aneurysms. Stops the embolic agent from migrating (moving) from its target location. It secures the embolic agent in position using a hollow mesh tube.
• Chemoembolization or radioembolization. Injects high-dose chemotherapy or radiation therapy, as well as embolic drugs, into the blood vessels feeding a tumor. It is for malignancies that begin in your liver or spread there.
• Sandwich technique. Removes the afflicted area entirely from circulation. Embolic agents are positioned both before and after the site of the aberrant tissue.
• Sac packing. A technique of cramming numerous coils into a treatment region to treat aneurysms.

Reasons for undergoing the procedure

Embolization provides either short-term or long-term treatment for a number of diseases by:

• Treats abnormal blood vessel connections.
• Cutting off the blood supply to tumors and other abnormal growths.
• Controlling or halting excessive bleeding.

Embolization can be employed to treat conditions in virtually any part of the body. You may benefit from the procedure if you have:

• Brain aneurysms
• Arteriovenous Malformations (AVM)
• Cancers and tumors which results to bleeding
• Uterine fibroids.
• Hyperactive spleen
• Varicocele
• Juvenile Nasopharyngeal Angiofibroma (JNA)
• Frequent nosebleeds (epistaxis)
• Gastrointestinal bleeding caused by disorders including diverticulosis and stomach (peptic) ulcers.
• Prolonged menstrual cycles or those with significant bleeding
• Retroperitoneal hematoma
• Vascular malformations involve atypical connections between arteries and veins.
• Traumatic damage to your liver, lungs, spleen, or other organs

Risks

Embolization entails numerous dangers. The location of the procedure and the type of embolic agent will affect your likelihood of suffering them. Risks that may exist include:

• Stroke or vision impairment can occur if embolic agents within the head migrate.
• Air embolism, where a blood vessel is blocked by an air bubble.
• Infections, such as the potentially fatal sepsis.
• Nerve injury (neuropathy).
• Bleeding or bruising where the puncture was made.
• Misplacement or migration of emboli.
• Soft tissue necrosis, particularly when more than one vessel is embolized.
• A contrast dye allergic reaction.

Before the procedure

Imaging tests are carried out by doctors to evaluate the blood vessels and flow near the treatment region. You might require a Magnetic Resonance Imaging (MRI), Computed Tomography (CT) scan, or ultrasound. Additionally, you might need to stop taking some drugs, like blood thinners.

Types of embolic agents

Your medical requirements and the type of blood vessel being treated determine the agent that is employed.

Types of emboli agents include:

• Liquid glue: Rapidly setting adhesive used to plug aberrant vessels.
• Liquid sclerosing agents: Substances that can damage tissue upon contact, including alcohol. Abnormal blood vessels close as a result of this.
• Balloons: The deployment of tiny balloons in a blood vessel to either temporarily or permanently obstruct it.
• Gelatin foam: Gelatin-based sponge-like substance that disintegrates after a few days.
• Particulate agents: Substances that permanently obstruct small vessels, such as spheres of different diameters.
• Metallic coils: Tiny platinum and stainless steel gadgets that can be inserted in a specific area.

During the procedure

What transpires during an embolization operation is as follows:

• You receive a light sedative to aid with relaxation. To numb the puncture site, your doctor will inject more drugs there.
• In the area of your wrist, groin, or neck, the interventional radiologist produces a tiny puncture in your skin.
• A catheter is advanced to the treatment location after being slid through the puncture.
• Interventional radiologists can see the treatment area and tools thanks to imaging technology like fluoroscopy.
• To get a better image of your blood vessels and blood flow, your doctor injects a specific dye through the catheter.
• After administering the embolic agent, the interventional radiologist checks to see if blood flow to the region has halted.
• The catheter is removed by the interventional radiologist when the embolization operation is finished. A bandage is placed over the cut. No big incisions or stitches are required.

After the procedure

The puncture site often hurts for the majority of people. Usually, this lasts a few days. Post-embolization syndrome, which some patients experience, involves fever, nausea, and vomiting. It can occur with any embolization technique, although uterine artery embolization is more typical.

Outcome

Most patients have to spend at least one night in the hospital. You are given painkillers throughout this period to keep you at ease.