Embolization Technique  Starch microspheres - Used to temporarily block

EMBOLIZATION blood supply to tumors. They are used in

 Embolization is a minimally invasive medical transarterial chemoembolization (TACE) to treat
procedure performed to intentionally block liver cancer.
blood flow to a specific area of the body. It is
commonly used to control bleeding, shrink
tumors, or treat vascular abnormalities such as PERMANENT EMBOLIZATION AGENTS:
aneurysms and arteriovenous malformations Permanent embolization agents provide long-term or
(AVMs). The procedure involves the injection of irreversible blood flow obstruction. These agents are
embolic agents into targeted blood vessels to used in cases where complete cessation of blood
obstruct circulation selectively. This technique is supply is required, such as in tumor treatment,
widely used in interventional radiology to vascular malformations, and aneurysm repair.
provide effective treatment with minimal 1. Particulate Agents - Particulate embolization
recovery time compared to traditional surgical involves injecting small particles into the
methods. bloodstream to block capillaries and small arteries.
EMBOLIZATION AGENTS These agents are often used in the treatment of
 Materials and substances used during tumors and uterine fibroids.
embolization procedures to block blood flow, Common types include:
stop and prevent bleeding, devascularize  Polyvinyl alcohol (PVA) particles –
organs, or occlude pathways. Biocompatible and widely used in tumor
 Categorized into temporary and permanent embolization.
types based on their ability to either degrade  Microspheres – Specially designed synthetic
over time or create lasting vessel occlusion. beads that lodge in blood vessels and
TEMPORARY EMBOLIZATION AGENTS: prevent circulation.
 Temporary embolization agents degrade  Embolizing beads – Small, calibrated
naturally over time, allowing for the restoration particles that offer precise control over
of blood flow after a controlled period. These are vessel occlusion.
primarily used in cases where temporary vessel  Acrylic polymers – Strong and durable
occlusion is necessary, such as in pre-surgical particles used for targeted embolization.
interventions or short-term treatment of 2. Liquid Agents - Liquid embolic agents are injected
hemorrhages. as a fluid and solidify upon contact with blood,
Common temporary agents include: creating a permanent occlusion. These agents are
 Autologous blood clot or patch - It is a used for treating vascular malformations and
temporary embolization agent adapted for large hemorrhages.
vessel occlusion procedures such as hemostatic Examples include:
embolizations but can also be used as a seal for  Cyanoacrylate (glue) – A fast-acting
a biopsy trajectory during lung and hepatic adhesive that permanently occludes blood
biopsies. vessels.
 Gelfoam (Gelatin foam) - A biologic substance  Ethanol – Induces vascular thrombosis and
made from purified skin gelatin. It is an permanent sclerosis of targeted vessels.
absorbable bioprosthetic material available as a
block (sponge or sheet) or as a powder.
  Onyx (ethylene vinyl alcohol copolymer) – A helps determine the best approach for
slow-solidifying agent that allows controlled treatment.
embolization. During the Procedure
 Lipiodol – An oil-based contrast medium that  The embolization procedure is typically
helps deliver embolic materials to target performed under local anesthesia with mild
locations. sedation or general anesthesia, depending on
3. Mechanical Agents the complexity of the case.
Embolization coils are manufactured in many  A catheter is inserted into a major artery,
configurations and sizes and produce permanent usually through the femoral artery in the groin,
vessel occlusion similar to surgical ligation. Coils are and guided to the target site using real-time
generally made from either stainless steel or fluoroscopic imaging. Once positioned correctly,
platinum. the selected embolic agent is injected, blocking
Examples include: the blood supply to the affected area. The
 Coil (Stainless Steel or Platinum) - to increase procedure usually lasts between 30 minutes to 3
the surface area and thereby increase the speed hours, depending on the complexity of the
and permanence of thrombosis. treatment.
 Vascular Plugs - Because of their size and shape,
the plugs have the potential of occluding larger- Risks / Benefits
sized vessels, and are used inside a larger sized What are the benefits of embolization?
sheath or guiding catheter. Embolization offers many benefits.
 This procedure quickly controls abnormal
How does an embolization procedure work? bleeding and has a high success rate.
Embolization is performed by placing a small  It’s gentler on your body than open surgery.
catheter inside the blood vessels that supply the Instead of an incision, there’s a small puncture
area that is bleeding. Carefully navigating the that causes minimal blood loss.
catheter, under image guidance, to the safest and  Most people resume daily activities within a
farthest point, a variety of different materials can week.
then be used to block the bleeding vessels.
What are the risks of an embolization
Embolization Procedure procedure?
Pre-procedure Preparations Embolization carries many risks. Your likelihood of
 Before undergoing embolization, patients must experiencing them depends on the location of the
undergo a series of diagnostic tests, including procedure and type of embolic agent. Potential risks
imaging studies such as CT scans, MRI, or include:
angiography to identify the exact location of the  Air embolism, when an air bubble blocks a blood
vascular abnormality. vessel.
 Patients may need to fast for several hours  Allergic reaction to contrast dye.a
before the procedure and discontinue certain  Bruising or bleeding at the puncture site.
medications, especially anticoagulants, to  Embolic agent misplacement or migration.
reduce the risk of excessive bleeding. A  Infections, including sepsis, which can be life-
consultation with the interventional radiologist threatening.
 Nerve damage (neuropathy).
 Soft tissue necrosis, especially when more than  Tiny beads filled with the radioactive isotope
one vessel is embolized. yttrium-90 are injected into the artery.
 Stroke or blindness if embolic agents in the head  The beads collect in the tumor and emit
migrate. radiation that destroys the tumor's blood supply.
Benefits:
SPECIALIZED EMBOLIZATION TECHNIQUE  Shorter recovery time than other therapies
1. CHEMOEMBOLIZATION  Fewer side effects than in other therapies
 A cancer treatment that blocks a tumor’s blood  Saves healthy liver tissue from radiation
supply. This treatment is also known as 3. SAC PACKING
transarterial chemoembolization (TACE). Refers to a medical procedure where a vascular sac,
 Chemoembolization delivers the drugs directly like an aneurysm, is completely filled with small coils
to the tumor. or embolic particles, essentially blocking off blood
 A palliative treatment for liver cancer. flow to that area while preserving the patency of the
 The procedure itself lasts 1-2 hours and parent blood vessel, typically used for saccular
observed for 2-4 hours afterward. aneurysms with a narrow neck where the coils can
PROCEDURE: be contained within the sac itself.
 A catheter is inserted into a blood vessel near Procedure:
the tumor.  A thin catheter is guided into the affected
 Chemotherapy drugs are injected into the artery artery.
that supplies blood to the tumor in the liver.  A microcatheter is advanced into the aneurysm
 The artery is then blocked off (embolized) with a sac.
mixture of oil and tiny particles.  Multiple coils or any embolic particles such as
Benefits: gelatin sponges are carefully deployed within
 The drugs stay in the tumor for a longer time, the sac until it is completely packed, effectively
which may kill more cancer cells. blocking blood flow to the aneurysm.
 Side effects are reduced because the drugs are Benefits:
trapped in the liver.  Preserves blood flow to the affected organ by
keeping the parent artery open.
2. RADIOEMBOLIZATION  Can be effective for treating aneurysms in
 Radioembolization is a minimally invasive various locations, including the brain, abdomen,
procedure that involves the precise placement and extremities.
of microscopic radioactive spheres
(microspheres) via a small catheter placed Advanced Techniques in Embolization
directly in blood vessels that supply a tumor in 1. Sandwich Technique.
the liver. A specialized embolization method that alternates
 Radioembolization can be used to treat liver embolic agents with therapeutic drugs to enhance
cancer that can't be removed with surgery. It treatment
can also shrink tumors so they can be treated  First embolization: Partially blocks blood flow.
with surgery or a liver transplant.  Drug injection: Localized treatment delivery.
PROCEDURE:  Final embolization: Seals the drug in place.
 A thin tube is inserted into an artery that Uses: Tumor treatment (TACE), arteriovenous
supplies blood to the liver. malformations (AVMs), and hemorrhage control.
Benefits: Enhances drug efficacy, reduces systemic Procedure:
side effects, and improves treatment precision.  A catheter is inserted into an artery
2. Stent-Assisted Coiling (SAC)  A small balloon on the tip of the catheter is
Used for wide-neck aneurysms, this method deploys inflated to stop blood flow
a stent to support coils inside the aneurysm sac.  The catheter is used to inject the glue into the
Procedure: artery
 Stent placement: Provides a scaffold in the Uses: Brain Surgery, Gastrointestinal Bleeding,
artery Varicocele Embolization
 Coiling: Coils fill the aneurysm, inducing clot
formation. LIQUID EMBOLIZATION
 Healing: Stent holds coils in place and  is a medical procedure used to treat vascular
promotes vessel repair. abnormalities, such as arteriovenous
Uses: Intracranial aneurysms, vascular malformations (AVMs), aneurysms, tumors, or
reconstruction. abnormal bleeding.
Benefits: Prevents coil migration, reduces  In this process, a liquid embolic agent is injected
recurrence, into the blood vessels to block or reduce blood
and maintains normal blood flow. flow to the targeted area. This helps prevent
3. Coil Embolization excessive bleeding, decrease blood supply to
also known as coiling or endovascular coiling, is a tumors, or treat vascular malformations.
minimally invasive procedure that treats blood  The liquid embolic agents solidify or harden
vessel abnormalities. upon contact with blood or tissue, sealing off the
vessel permanently or temporarily.
Procedure:
 A catheter is inserted into an artery, usually in BALLOON EMBOLIZATION
the groin Balloon embolization is a minimally invasive
 The catheter is guided to the abnormal blood procedure used to block blood flow to certain blood
vessel vessels by inflating a balloon within the vessel. The
 Small platinum coils are inserted through the procedure is often employed in situations such as:
catheter into the abnormal blood vessel  Treating vascular malformations, such as
 The body forms a blood clot around the coils to arteriovenous malformations (AVMs).
block off the abnormal blood flow  Managing aneurysms by isolating the affected
Uses: used to treat brain aneurysm,can be area to prevent rupture.
performed on both ruptured and unruptured  Stopping abnormal bleeding, such as in trauma
aneurysms, often used when open surgery is or gastrointestinal hemorrhage.
associated with higher risk. The inflatable balloon, usually made of
Benefits: less invasive and requires significantly less biocompatible material, is temporarily or
recovery time than open surgery. permanently placed within the blood vessel to
4. Glue Embolization create a mechanical blockage. Often, balloon
a chemical used to block arteries and treat vascular embolization is combined with liquid embolic agents
malformations and tumors. The most common type or other embolization materials to enhance efficacy.
of embolization glue is n-butyl cyanoacrylate
(NBCA).
TRANSCATHETER ARTERIAL EMBOLIZATION  Common Uses: Cancer treatment often used for
(TAE) tumors, such as liver cancer, where both
 Purpose: TAE is primarily used to block or blocking the blood supply and delivering
reduce blood flow to a specific area of the body chemotherapy directly to the tumor improves
to treat conditions like tumors, bleeding, or treatment outcomes. Vascular malformations:
vascular malformations. It's used when it's Used to treat abnormal blood vessels by
necessary to control blood supply, prevent blocking blood flow and delivering drugs to help
further bleeding, or shrink tumors. prevent growth or recurrence.
 How It Works: A catheter is inserted through a
small incision (often in the groin) and advanced
through the blood vessels to the targeted area.
Embolic agents, such as coils, particles, or foam,
are then injected into the blood vessel to
obstruct or reduce blood flow to the target area.
The embolization cuts off the oxygen and
nutrients to the targeted tissue (e.g., a tumor),
potentially shrinking it or preventing further
growth.
 Common Uses: Cancer treatment To block blood
flow to tumors, particularly in organs like the
liver. Stopping bleeding: In cases of trauma,
post-surgery bleeding, or gastrointestinal
bleeding. Vascular malformations: To block
abnormal blood vessels like arteriovenous
malformations.
DRUG-ELUTING EMBOLIZATION (DEE)
 Purpose: DEE builds on the concept of TAE by
adding drug delivery to the embolization
process. In this technique, the embolic agents
(particles or beads) are coated or impregnataed
with a drug that is slowly released over time to
treat the target tissue.
 How It Works: Similar to TAE, a catheter is
inserted into the bloodstream and guided to the
targeted area. Embolic agents coated or loaded
with drugs (such as chemotherapy drugs or anti-
inflammatory drugs) are injected into the blood
vessels supplying the target area. As the
embolic agents block blood flow, they also
release the drug directly to the tumor or
affected tissue, allowing for localized, controlled
drug delivery.