Embolization – What is it?

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Embolization in short is the obliteration of blood vessels feeding diseased tissue like tumors, vascular malformations to deprive them from flow which ultimately interrupts the process by which disease progresses. Embolization can also use the same principle of obliteration to deliver medication in a precise manner to the affected organ, to quickly stop bleeding and hemorrhage in a vessel.

Embolization is a very advanced form of treatment where sophisticated tiny equipment is used to navigate the body’s vasculature without the need for open surgery, wound incision or significant downtime. It is a medicine of the future.

Few examples to illustrate the advanced nature of this procedure can be cited. A brain aneurysm can be shut down with tiny coils, a brain vascular malformation can be shut down with glue without the need for open skull, chemotherapy medicines can be delivered to a liver tumor directly avoiding systemic side effects, a life threateneing bleeding vessel near a stomach ulcer can be rapidly occluded, fibroids in the uterus can be treated by cessation of blood flow in a same day surgery without the need for any incision or significant downtime.

What is exactly injected into the uterine arteries?

Tiny particles made of medical grade material are gently injected towards the fibroids. The particles ultimately clog the abnormal vessels feeding the fibroids. This initiates the progressive demise of the fibroids. The particles used at our clinic are FDA approved and proven effective for a long time now.

What happens to the particles in my body?

The particles will stay trapped into the fibroid vessels. As the fibroids shrink, the particles become engulfed in the same area. They are not biologically active and so besides treating the fibroids themselves, the particles are harmless. We have seen patients in the past pass some of the particles in the sloughed off fibroid tissue in the uterine cavity. This is also harmless.

How effective is uterine fibroid embolization? Could there be a failure?

Embolization in the context of fibroids has been proven very effective in many studies. When done by a skilled, experienced specialist, success is usually the case. Failures can occur if embolization was not complete, a suitable endpoint is not recognized, other neighboring vessels are contributing to feeding the fibroids but not treated simultaneously or if there are technical challenges such as difficult anatomy, propensity to vessel spasm among others.

Figure 1 This picture illustrates how fibroid tumors can appear anywhere in the uterus

 

Figure 2 A tiny catheter is inserted at the hip level and advanced into the uterine artery feeding the fibroids

Figure 3 Here a close view of how the beads distribute to the vessels feeding the fibroids

 

Before embolization       3mo after embolization         6mo after embolization     1yr after embolization

Figure 4 From left to right a large fibroid treated with embolization has significantly shrunk overtime