Embolization-
Embolization is a minimally invasive treatment that blocks one or more blood vessels or abnormal vascular channels. Catheter embolization places medications or synthetic materials called embolic agents through a catheter into a blood vessel to block blood flow to an area of the body. It may be used to control or prevent abnormal bleeding, close off vessels supplying blood to a tumor, eliminate abnormal connections between arteries and veins, or to treat aneurysms. Embolization is a highly effective way to control bleeding and is much less invasive than open surgery.
What is Catheter Embolization?
In a catheter embolization procedure, medications or synthetic materials called embolic agents are placed through a catheter into a blood vessel to prevent blood flow to the area.
What are some common uses of the procedure?
Catheter embolization can be applied to almost any part of the body to control or prevent abnormal bleeding. Common health problems that can be treated using catheter embolization include:
- Bleeding that results from a traumatic injury. Controlling bleeding into the abdomen or pelvis from injuries caused by a motor vehicle accident is especially suitable for this treatment.
- Bleeding from gastrointestinal tract lesions such as ulcer or diverticular disease.
- Embolization is commonly the first line of treatment in gastrointestinal bleeding of any cause.
- Bleeding from vascular malformations. For example, abnormal vascular channels can form in between arteries and veins in the circulatory system of the lungs. Catheter embolization can be used to eliminate these abnormal connections.
- Tumor bleeding. Embolization can help reduce the pain associated with tumor bleeding.
- Long menstrual periods or heavy menstrual bleeding that results from uterine fibroid tumors. Embolization may prove to be an excellent alternative to hysterectomy, the surgical removal of the uterus. Because fibroids have a large blood supply, embolization can shrink and control heavy menstrual bleeding by interrupting the blood supply. See the Uterine Fibroid Treatment page for more information.
Catheter embolization is also performed to:
- Close off vessels that are supplying blood to a tumor, especially when the tumor is difficult or impossible to remove. Embolization may also be used to administer chemotherapy. After embolization a tumor may shrink or it may continue to grow but more slowly, making chemotherapy or surgery a more effective option.
- Eliminate an arteriovenous malformation or arteriovenous fistula (AVF) (abnormal connection or connections between arteries and veins). These passageways, which may occur anywhere in the body including the brain or spinal cord, act like a short circuit to prevent blood from fully circulating and delivering oxygen where it is needed.
- Treat aneurysms (a bulge or sac formed in a weak artery wall) by either blocking an artery supplying the aneurysm or closing the aneurysmal sac itself as an alternative to surgery.
- Treat varicoceles (enlarged veins) in the scrotum that may be a cause of infertility.
- See the Varicocele Embolization page for more information.
- Decrease the size of congenital venous malformations (a tangle of veins that did not develop into a normal straight vein) in order to decrease pain, swelling and clot formation.
- Catheter embolization may be used alone or combined with other treatments such as surgery or radiation.
Types of embolic agents use for embolization procedure?
Your physician will select an embolic agent depending on the size of the blood vessel or malformation and whether the treatment is intended to be permanent or temporary. These include:
Gelfoam™, a gelatin sponge material, which is cut into small pieces that are injected into an artery and float downstream until they can go no further. After a period ranging from a few days to two weeks, the material dissolves. Particulate agents, including Polyvinyl alcohol (PVA) and gelatin-impregnated acrylic polymer spheres, which are suspended in liquid and injected into the bloodstream to block small vessels. These agents are used to block blood vessels permanently.
Various sized metallic coils or other mechanical devices made of stainless steel or platinum are used to block large arteries. They can be positioned very precisely to stop bleeding from an injured artery or stop arterial blood flow into an aneurysm.
Liquid sclerosing agents such as alcohols, which are used to destroy blood vessels and vessel malformations. Filling a blood vessel or vascular abnormality with this liquid agent causes blood clots to form, closing up the abnormal vascular channels.
Liquid glue. When injected into the target channel that needs to be closed off, it hardens quickly. Select chemotherapy medications, such as doxorubicin or irinotecan, may be used in the embolization treatment of tumors.
What are the Benefits of Embolization?
- Embolization is a highly effective way of controlling bleeding, especially in an emergency situation.
- Worldwide success rates of 85 percent and higher have been reported in women treated with embolization for uterine fibroids.
- Embolization is much less invasive than conventional open surgery. As a result, there are fewer complications and the hospital stay is relatively brief often only the night after the procedure. Blood loss is less than with traditional surgical treatment, and there is no obvious surgical incision.
- This method can be used to treat tumors and vascular malformations that either cannot be removed surgically or would involve great risk if surgery was attempted.
- No surgical incision is necessary only a small nick in the skin that does not need stitches.
What conditions does embolization treat?
Embolization may be used for conditions affecting nearly every area of your body. The procedure can help you if you have:
- Arteriovenous malformations (AVM).
- Brain aneurysms.
- Cancers and tumors that cause bleeding.
- Frequent nosebleeds (epistaxis).
- Gastrointestinal bleeding (hemorrhage) from conditions such as stomach (peptic) ulcers and diverticulosis.
- Long menstrual periods or ones with heavy bleeding.
- Overactive spleen.
- Retroperitoneal hematoma, bleeding in the space behind your abdominal wall lining.
- Traumatic injuries affecting certain organs, including your spleen, liver and lungs.
- Uterine fibroids.
- Varicocele, swollen veins in your scrotum.
- Vascular malformations, including abnormal connections between arteries and veins.
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