devascularisation

Devascularisation is a medical term for procedures that reduce or interrupt the blood supply to a tissue, organ, tumor, or region. The aim is to decrease bleeding, shrink a lesion, or make surgical resection safer by lowering its vascularity. Devascularisation can be achieved by surgical means or by radiologic interventions and may be temporary or permanent depending on the method and target tissue.

Common methods include ligation or clipping of feeding arteries during open or laparoscopic procedures; cutting or coagulating vessels; thermal ablation; and, in radiology, transarterial embolization using particles, coils, or glues to occlude the arteries supplying the area. In some contexts, devascularisation is combined with tissue resection or followed by debulking of a tumor. In hemorrhoidal disease, Doppler-guided dearterialization and ligation is a recognized approach to reduce arterial inflow to hemorrhoids.

Indications for devascularisation include control of acute or recurrent bleeding, reduction of tumor vascularity prior to surgery, palliation of bleeding from tumors, and organ-sparing strategies in selected cases. The choice of method depends on the target tissue, the clinical goal, and the availability of expertise or technology.

Risks and limitations include unintended ischemia to normal tissue, infection, necrosis, pain, or postembolization syndrome; incomplete devascularisation or development of collateral circulation that limits effectiveness; and potential need for additional procedures if symptoms recur.

Devascularisation is related to, but distinct from, embolization and ligation. Its precise approach is varied across medical specialties and tailored to specific clinical contexts.