Embolization makes it possible to obstruct one or more vessels which nourish a lesion (tumor, fibroid) or which constitute a vascular lesion. How’s it going ? What indications? What are the side effects after the procedure? What contraindications?
An embolization is a procedure that consists of obstructing an artery or a vein. Why do an embolization? How is an embolization performed? Who performs an embolization? What are the risks and precautions to be aware of?
Definition: what is an embolization?
Embolization is a minimally invasive therapeutic intervention consists in clog an artery or vein. “Embolization is the scientific term that defines the act of occluding, block a vessela vein or an artery in order to treat numerous pathologies”, according to Romaric Loffroy, head of the radiology and medical imaging department at Dijon University Hospital. It makes it possible to prevent the dysfunction of a blood vessel or the proliferation of a pathology such as in angiomas for example. Embolization is often used in oncology, especially in the cancer du foie to stop the blood supply to the tumor and thus make it necrotic. It is also frequent in cardiovascular pathology in case of malformation of a vessel. The artery can be blocked with metal coils or a thrombogenic substance, natural or synthetic, mechanical or liquid, which promotes the formation of a blood clot.
Indications: why do an embolization?
Our expert identifies three main categories of embolization:
→ Hemostasis embolization: “It is performed when there is blood loss after surgery or trauma. Embolization may also be indicated in the context of postpartum hemorrhage, after childbirth or when a tumor is bleeding. It is It’s about occluding the bleeding vessel.”
→ Tumor embolization: “We perform chemo-embolization or radio-embolization on a tumour. For patients who do not suffer from extensive disease and who can be treated locally, this makes it possible to intervene and treat the tumor directly. It can be benign tumors such as a prostate adenoma or a uterine fibroid – the adenoma or fibroid is treated while preserving the prostate or the uterus – or malignancies such as liver cancers or liver metastases.”
→ “Embolization also allows to treat all vascular pathologies and in particular aneurysmal, in the brain – in neuroradiology – or venous, elsewhere in the rest of the body. This may relate to the treatment of varices pelvic in women, sometimes causing chronic pain, or varicoceles in men.
“This is a minimally invasive procedure, under local anesthesia, which generally does not require any special preparation. A biological assessment is carried out, in particular a coagulation assessment to ensure that there are no hemostasis disorders. The patient can eat “light” before the intervention but it is not necessary to be on an empty stomach, explains Prof. Loffroy.
The procedure takes place in an angiography room, most often on an outpatient basis. “This is an image-guided intervention performed by a radiologist interventional from a small percutaneous puncture point, to the skin. An artery or vein is punctured under ultrasound guidance. Catheters and micro-catheters are then introduced into the vessels that need to be blocked, painlessly. They will be used to inject the product of contrast which makes it possible to visualize the zone of intervention. Embolization of the blood vessel is then performed using metal springs or solidifying fluids.” explains our expert.
What are the side effects of an embolization?
The complications are rare and minor, compared to conventional surgery. Depending on the area where the embolization is performed, side effects vary. “It may be a trivial hematoma at the puncture site, especially on the arteries, in patients who are under-anticoagulants. In addition, embolization on an organ such as the kidney, liver, spleen, can be the cause of a spost-embolization syndrome with a slight fever for two to three days, nausea or even slight pain. These pains are very well controlled by simple analgesics in general”adds Professor Loffroy.
What are the contraindications for embolization?
According to our expert, “there are no major contraindications. However, embolization may not be possible for technical reasons in some cases. Patients must be selected”, he acknowledges.
Thanks to Professor Romaric Loffroy, head of the department of radiology and diagnostic and therapeutic medical imaging at the Dijon University Hospital.