Embolization

Why do I need embolization?

Most commonly it is used to control or prevent abnormal bleeding. A typical example is in the setting of trauma where there has been a major vascular injury with active bleeding (embolization for trauma).

It can be used to control haemoptysis — severe bleeding from your lungs (bronchial embolization) or from your intestines (embolization for intestinal bleed)

The other indication include tumor embolization or uterine fibroid embolization

whose purpose is to shrink the tumor and allows easier operative treatment or even in the latter case it represents a reasonable alternative to surgery.

Testicular vein embolization is a recognized treatment for male infertility.

What will happen?

Testicular embolization is done on an outpatient basis; for any other indication, you will have to be admitted. You will be brought to the Interventional Radiology Suite where the interventional radiologist (a doctor specially trained in that procedure) and radiographer will explain the procedure and answer your questions. The length of the procedure is usually 60 to 90 minutes but may take much longer depending on the vascular anatomy. After completion, you will be either monitored in the radiology department for 2-3 hours or be transferred to your ward.

Do I need any test before the procedure?

You will be asked to have following blood tests:

Urea & electrolytes — to assess if your kidneys will tolerate contrast. Pl/PTT/Platelets — to assess the risk of post procedural bleeding. You should discuss any allergy history (particularly to Iodine) with the radiologist prior to booking the procedure.

The embolization procedure

The procedure starts as general angiography.Under the X-ray guidance the doctor will pass a guide-wire into the vessel of interest and over it, advance a

catheter. After injection of contrast (X-ray dye), a series of X-rays will be taken to determine the best position for the delivery of embolization material. The doctor will decide whether to use temporary agent like gelatin sponge, or the permanent one (Polyvinyl alcohol articles, embospheres, liquid glue or various coils made of stainless steel or platinum). Injection of contrast (X-ray dye) will confirm that the bleeding or the blood flow into tumor has stopped.

What are the risks?

Similar to diagnostic angiography.

Additional risks are specific to the type of the procedure.

What will I feel? Does it hurt?

During the catheter placement similar to angiography.

You may experience some pain during first 24 hours after the procedure; it is easily controlled by per oral or IV painkillers.

Post-embolization syndrome sometimes occurs after tumor embolization; it consists of high fever, general body weakness, nausea and vomiting. It usually does not last more than 48-72 hours.

When will I get my results?

In most cases the radiologist will be able to discuss the results with you and your family immediately after the procedure and advice if the procedure was a technical success.

When will I resume my normal activities?

This will depend on several factors — particularly how you tolerated the procedure and if any other intervention or operation is needed. The radiologist and attending physician/surgeon will discuss the options with you.

 

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