| This procedure is reviewed by a physician with
expertise in the area presented and is further reviewed
by committees from the American College of Radiology
(ACR) and the Radiological Society of North America
(RSNA), comprising physicians with expertise in several
radiologic areas.
What is Catheter Embolization?
Embolization, a fairly new treatment method, is a
way of occluding (closing)—or at least drastically
reducing—blood flow to one or more blood vessels
that are doing more harm than good. One of a variety
of materials, depending on whether vessel occlusion
is to be temporary or permanent, is passed through
a catheter, its tip lying in or near the vessel to
be closed. This approach can be used to control or
prevent abnormal bleeding as well as to shut down
the vessels that support a growing tumor. Therapeutic
embolization may also serve to eliminate an arteriovenous
malformation (AVM), an abnormal communication between
an artery and a vein. The term "embolization"
derives from embolus, which can be any object that
circulates in the bloodstream until it lodges in a
blood vessel—in this case, a synthetic material
or medication specially designed to occlude the blood
vessels.
What are some common uses of the procedure?
Catheter embolization may be used as the sole treatment,
or may be combined with another method such as surgery
or radiation. In some cases it is an emergency means
of controlling bleeding until it is possible to deliver
the final treatment.
- The most common use of catheter embolization
is to control bleeding from injury, a tumor, a stomach
ulcer or some other cause on an emergency basis.
Controlling bleeding into the abdomen or pelvis
from injuries caused in an auto collision is especially
suitable for this approach.
- Occluding the blood vessels that feed a tumor
can help control symptoms when the tumor cannot
be removed or might be difficult and risky to remove,
such as liver cancer. All tumors need a rich supply
of blood to continue growing. After embolization
a tumor may shrink, or it may continue to grow but
more slowly than before. It now is possible to
combine the embolic material with chemotherapy.
- Fibroid tumors of the uterus, though not malignant
(cancerous), may cause long-lasting menstrual periods
or heavy menstrual bleeding. They also may produce
pain in the pelvic area, the back or the legs, as
well as pressure on the bladder or bowel. Embolization
may prove to be an alternative to the standard treatment:
surgical removal. Because
fibroids have a large blood supply they will tend
to shrink or even disappear if this blood supply
is interrupted. Multiple fibroids can be treated
in the same session. (See the Uterine Fibroid Embolization
page on the RadiologyInfo.org Web site for a detailed
description.)
- Embolization is used increasingly often –
again as an alternative to surgery – for treating
arteriovenous malformations (AVMs). Although these
lesions may occur anywhere in the body, those in
the brain or spinal cord often are treated by embolization
because of potentially severe complications of surgical
treatment. When an artery and vein are
connected it has the effect of a “short circuit”
that prevents blood from going to where it is needed;
instead it is pumped through the connection (shunt)
and back to the heart. An AVM is a rare abnormality
that may cause pain and loss of function; embolization
may control these symptoms. It also has been used
to plug the artery supplying an aneurysm (ballooning
out of the artery wall) within
the brain if, as is often the case, it is difficult
to reach surgically.
- Hemangiomas are highly vascular tumors often
found on the face, where they may deform and discolor
the skin. Embolization is a sensible alternative
to surgical removal, which may leave an unsightly
scar.
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