Embolization (or embolisation) refers to the passage and lodging of an embolus within
the bloodstream. It may be of natural origin (pathological), in which sense it is
also called embolism, for example a pulmonary embolism; or it may be artificially
induced (therapeutic), as a hemostatic treatment for bleeding or as a treatment for
some types of cancer by deliberately blocking blood vessels to starve the tumor
cells.
In the cancer management application, the embolus, besides blocking the blood supply
to the tumor, also often includes an ingredient to attack the tumor chemically or
with irradiation. When it bears a chemotherapy drug, the process is called
chemoembolization. Transcatheter arterial chemoembolization (TACE) is the usual
form. When the embolus bears a radiopharmaceutical for unsealed source radiotherapy,
the process is called radioembolization or selective internal radiation therapy
(SIRT).
Embolization involves the selective occlusion of blood vessels by purposely
introducing emboli, in other words deliberately blocking a blood vessel.
Embolization is used to treat a wide variety of conditions affecting different
organs of the human body.
Bleeding
The treatment is used to occlude:
Growths
The treatment is used to slow or stop blood supply thus reducing the size of the tumour:
The procedure is carried out as an endovascular procedure by an interventional
cardiologist in an interventional suite. It is common for most patients to have the
treatment carried out with little or no sedation, although this depends largely on
the organ to be embolized. Patients who undergo cerebral embolization or portal vein
embolization are usually given a general anesthetic.
Access to the organ in question is acquired by means of a guidewire and catheter(s).
Depending on the organ this can be very difficult and time-consuming. The position
of the correct artery or vein supplying the pathology in question is located by
digital subtraction angiography (DSA). These images are then used as a map for the
radiologist to gain access to the correct vessel by selecting an appropriate
catheter and or wire, depending on the 'shape' of the surrounding anatomy.
Once in place, the treatment can begin. The artificial embolus used is usually one
of the following:
Once the artificial emboli have been successfully introduced, another set of DSA images are taken to confirm a successful deployment.