About the Procedure
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Catheter embolization is the technique of deliberately occluding a blood vessel to obtain a therapeutic effect.
Small tubes called catheters can be navigated to just about any blood vessel in the body and specialized agents delivered precisely to obtain result.
used with imagination the catheter can become an extremely powerful surgical tool.
Catheter embolization may be used as the sole treatment or may be combined with other treatments such as surgery or radiation.
- Active Bleeding: The most common use of catheter embolization is to control bleeding.Thisapproach is ideally suitable bleeding from an 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 accident is especially suitable for this approach.
- Tumour Embolization: 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 in 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 is now possible to combine the embolic material withchemotherapy,which may treat the tumormore effciently.
Fibroid Embolization: Fibroid Tumorsof the uterus, though not malignant (cancerous), may cause long menstrual periods or heavy menstrual bleeding. They also may produce pain in the pelvic area or the back, as well as pressure on the bladder or bowel. Embolization may prove to be an alternative to the surgical removal of the uterus (hysterectomy). 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.
Vascular Malformations: Embolization is an excellent therapy for treatingarteriovenous malformations(AVMs). These lesions may occur anywhere in the body, including the brain or spinal cord. AVMs are treated because the abnormal connection of the artery and vein has the effect of a "short circuit." The blood does not go where it is needed; instead it is pumped through the connection (shunt) back to the heart. AVMs are commonly treated by embolization because of potentially severe complications likely from surgical treatment. An AVM is a rare abnormality that may cause pain and loss of function; embolization may control these symptoms effectively.
- Aneurysms: Embolization may also be used to plug the artery supplying an aneurysm (ballooning out of the artery wall) or obliterate the aneurysm within the brain as an alternative to surgery.
- 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.
- In the management of intra cranial arteriovenous malformation (AVM), embolization with newer liquid embolic agents can be curative with lower mortality and morbidity compared to surgery.
Patient Preparation and Post Procedure
For the patient the procedure is very similar to angiography
A small amount of blood will be drawn before starting the procedure to make sure that your kidneys are working and that your blood will clot normally. A small dose of sedative may be given through the IV line to lessen your anxiety during the procedure.The area of the groin or arm where the catheter will be inserted is shaved.
In most patients the upper thigh is cleaned, and numbed with local anesthetic. The radiologist will make a small needle puncture in the skin where the catheter can be inserted into an artery. The catheter is then guided through the arteries to the area to be examined. After the contrast material is injected through the catheter and reaches the blood vessels being studied, several sets of x-rays are taken.During injection of the contast agent you may be asked to hold your breath for a few seconds. Most people get a warm feeling in the region of examination during theinjection of contrast
Following the procedure the tubes are taken out from the puncture site and compression given for a few minutes to stop the bleeding . The patient is advised to keep the leg that was punctured straight for 6 – 8 hours . The patient is allowed to walk after 12 hours. At times a closure device may be used to close the puncture site enabling the patient to walk after an hour.
Most patients may have some pain in the region embolized for the next few days .The pain will respond to pain killers
Though rare, any vascular Interventional procedure carries the following risks.
1. The procedure may fail and one may have to resort to surgery.
2. A normal vessel may get blocked and the patient may suffer due to lack of supply to that region.
3. The area may get worse due to a blood clot passing into normal vessels and may even result in death
4. Drugs including the dye used for angiography can produce an allergic reaction which can rarely be severe and dangerous to life.
5. Patient may develop bleeding from the site of puncture for angiography in the leg or arm; this can be stopped by compression for a few minutes.
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Bleeding From The Leg (Pseudoaneurysm)