What is Vascular Embolization?

Vascular embolization, sometimes also called as endovascular embolization, involves the introduction of embolic agents through a small nick in the skin directly into the blood vessel using a thin tube called a catheter. Common embolic agents used include coils, particles, alcohol and glues. Under imaging guidance using techniques like fluoroscopy or CT scanning, these embolic agents are pushed through the catheter into the blood vessel to create an occlusion or block. This restricts or stops blood flow to certain areas like tumors or areas of heavy bleeding.

The procedure is minimally invasive as it does not require open surgery. It is typically done under local anesthesia with sedation. Patients experience less pain, shorter hospital stays, faster recovery times and return to normal activities compared to traditional open surgeries. Vascular embolization provides definitive treatment for certain conditions and can help avoid or delay the need for major open surgeries in some cases.

Uterine Fibroid Embolization

One of the most common applications of Vascular Embolization is for the treatment of uterine fibroids. Uterine fibroids or leiomyomas are non-cancerous tumors arising from the muscle layers of the uterus. They affect around 70-80% of women by the age of 50. Common symptoms include heavy bleeding, painful periods, pressure symptoms and bloating.

Traditional treatment options included hormonal medication, myomectomy (surgical removal of fibroids) or hysterectomy (removal of the uterus). Uterine fibroid embolization (UFE) provides an alternative to surgery. In this procedure, the uterine arteries supplying blood to the fibroids are embolized using small gelatin or glass beads. This causes the fibroids to shrink over time by depriving them of their blood supply. Studies have shown UFE to be as effective as surgery in controlling symptoms with less post-procedure pain and faster recovery. Many women can return to normal activities within a week of the procedure. UFE has revolutionized treatment by offering a minimally invasive option to hysterectomy in appropriately selected patients.

Cancer Treatment

Vascular embolization is also being increasingly used in the treatment of certain cancers. It is used to restrict blood flow to tumor sites prior to surgery or other interventions like radiation or chemotherapy to shrink the tumor size. Cutting off the blood supply can lead to cancer cell death in these areas.

Some examples include embolization of hypervascular liver tumors before surgical removal of liver segments, embolization of kidney cancers before nephron-sparing surgeries, and embolization of uterine fibroids if they co-exist with endometrial cancers. Pre-operative embolization makes later surgeries safer and easier by reducing intra-operative blood loss. It also helps improve oncologic outcome in some cancers by facilitating complete surgical removal with clear tumor margins.

Embolization is also used along with other treatments in certain advanced or inoperable cancers like hypervascular metastases to the lungs from cancers like colon or renal cell cancers. Eliminating blood supply to tumors can help control tumor progression and related symptoms like uncontrolled bleeding in these cases. Vascular embolization provides an important non-surgical option for both curative and palliative treatment in select oncology patients.

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