Embolizing

Embolizing refers to the deliberate occlusion of blood vessels to stop or reduce blood flow to a target tissue or lesion. It is performed by interventional radiologists or vascular specialists using catheter-based techniques guided by imaging, often fluoroscopy.

During embolization, a catheter is navigated from a vascular access point to the arteries feeding the target area. An embolic agent is then released to achieve occlusion. Materials include mechanical devices such as coils and plugs; particulate agents such as polyvinyl alcohol particles and microspheres; gelatin sponge; and liquid adhesives such as n-butyl cyanoacrylate. Some procedures use temporary, resorbable materials to allow reperfusion later, while others aim for permanent vessel occlusion.

Indications for embolizing include control of acute or refractory bleeding; preoperative devascularization of hypervascular tumors; treatment of arteriovenous malformations and fistulas; and management of vascular lesions in organs such as the liver, uterus, kidneys, and spleen. In oncology, hepatic arterial embolization or chemoembolization is used to reduce tumor blood supply and deliver therapy locally, potentially shrinking tumors or slowing progression.

A typical procedure involves access via the femoral or radial artery, selective catheterization of feeding vessels, angiographic confirmation of targets, and careful injection of embolic material until flow is reduced or stopped. Post-procedure imaging ensures adequacy of occlusion and evaluation of collateral flow.

Risks include non-target embolization leading to ischemia of healthy tissue, post-embolization syndrome (pain, fever, nausea), infection, vessel injury, allergic reactions to contrast, and radiation exposure. Benefits include effective bleeding control, symptom relief, tumor devascularization, and, in some cases, avoidance of invasive surgery.