Vascular embolization is a minimally invasive endovascular procedure that blocks or reduces blood flow to certain areas of an organ, a tumor or other space occupying lesion. By selectively blocking the blood vessels that supply an area, embolization can help in treating various medical conditions. This procedure provides an effective treatment option with less risk, lower cost and a shorter recovery time compared to conventional open surgery.
What is Vascular Embolization?
Embolization is done by inserting a catheter through a small nick in the skin into an artery or vein. Under imaging guidance like fluoroscopy or CT scan, the catheter is navigated through blood vessels until it reaches the target site. Then tiny particles, coils or liquid agents known as embolic materials are injected through the catheter to block the blood vessel. As the vessel gets clogged, blood flow and oxygen supply to the targeted area reduces, which treats the condition effectively.
Conditions Treated with Embolization
Uterine Fibroid Embolization
Uterine fibroids are non-cancerous tumors that grow in or on the uterus. They can cause heavy painful periods, bladder pressure and menstrual problems. Uterine fibroid embolization blocks the blood vessels supplying the fibroids, causing them to shrink and symptoms to reduce. It is an effective minimally invasive alternative to hysterectomy for treating fibroids.
Hepatocellular Carcinoma Embolization
Hepatocellular carcinoma or liver cancer can be treated using embolization to cut off its blood supply. Transarterial chemoembolization (TACE) involves injecting chemotherapeutic agents along with embolic particles to shrink tumors. It helps improve survival and quality of life for some patients. TACE can be repeated if needed and often provides palliation when surgical resection is not possible.
Kidney Cancer Embolization
Renal cell carcinoma or kidney cancer can be embolized to reduce tumor size or as palliative treatment. Renal artery embolization works by blocking the renal arteries, depriving the cancerous renal mass of oxygen and nutrients. This causes tumor necrosis and helps relieve pain, bleeding and other symptoms. It serves as a bridge to surgery or improves outcomes if surgery is not possible.
Procedural Details and Benefits
How is Vascular Embolization Performed?
Vascular Embolization is usually done under local anesthesia with mild sedation. The surgeon makes a small nick in the groin or neck to access the femoral or carotid artery. A thin hollow catheter is then maneuvered through these arteries using X-ray guidance until it reaches the target blood vessel. Contrast dye is injected to visualize vessels and position the catheter exactly.
Embolic particles, liquids, coils or plugs are then injected through the catheter into the vessel supplying the target area. This blocks blood flow, cutting oxygen supply. Imaging confirms complete blockage. The catheter is removed and pressure applied to prevent bleeding. Patients can resume normal activities in 1-2 days with minimal post-procedure care needed.
Benefits of Vascular Embolization
- Minimally invasive - no large incisions needed
- Low risk of complications compared to open surgery
- Short hospital stay of 1-2 days usually
- Quick recovery time without long rehabilitation
- Useful for high-risk patients who cannot undergo surgery
- Can treat multiple tumors or sites in one session
- Repeatable procedure if needed
- Cost effective compared to lengthy surgeries and hospital stays
- Preserves organ function better than surgical removal
Risks and Complications
As with any medical procedure, there are some risks with vascular embolization too. However, the risks are generally lower than open surgical procedures. Some potential but rare complications include:
- Infection of the insertion site
- Excessive bleeding requiring transfusion
- Damage to nearby blood vessels or organs
- Organ failure in rare cases if too many vessels are blocked
- Migration of embolic agents to unintended locations
- Incomplete embolization with residual tumor growth
- Recurrence of tumors with regrowth of vessels over time
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