Transcatheter Embolization

First described by Brooks in 1930 as vessel occlusion for closing of arteriovenous

fistula

Transcatheter embolization is a procedure that uses an angiographic approach to

create an embolus in a vessel, restricting blood flow. Numerous clinical indications
for this procedure exist, including the following:

• Stop blood flow to a site of pathology.

• Reduce blood flow to a highly vascular structure and tumor before surgery.

• Stop active bleeding at a specific site.

• Deliver a chemotherapeutic agent

Indications

Post-traumatic Hemorrhage

Occlusion of blood supply to highly vascular neoplasm

Reduction of bleeding during and/or after surgical procedures

Since this method is used in high-risk cases, there are no contraindications

Electrocoagulation - used for diagnosed tumors, hemangioma, and arteriovenous

fistulas.

The mentioned method is an example of a procedure for occlusion.

Lesions amendable to embolization
a. Aneurysm
b. Pseudoaneurysm
c. Hemorrhage
d. Neoplasms
• Malignant
• Benign
e. Arteriovenous malformations (AVM)
f. Arteriovenous fistula (AVF)
g. Infertility (varicocele)
h. Impotence due to venous leakage
i. Redistribution of blood flow
Materials used for this process are usually naturally occuring particulates such as
autogenous and autologous blood clots, and tissue fragments(fat, muscle), but
with synthetic agents, they have become obsolete.
Small vessel occluders
Synthetic agents
Solid (resorbable)
Gelatin sponge (Gelfoam)
Oxidized cellulose (Oxycel)

Solid (permanent)
Polyvinyl alcohol (PVA) sponge
Silicone beads
Plastic beads

Liquid
Isobutyl-2-cyanoacrylate (IBCA; Bucrylate)
Ethanol (absolute)
Hypertonic glucose
Large vessel occluders
Mechanical systems
Coils (stainless steel with threads)
Plain threads (wool, Dacron, silk)
Bristle brushes

Balloon systems
Non-detachable balloon systems
Detachable balloon systems
Controlled leak balloon systems

Other systems
Chemoembolization
Electrocoagulation
Laser-induced occlusion
Percutaneous stents (covered)
Ultrasound, CT, or MRI may be used before the procedure.

The patient’s vital signs should be monitored during the procedure.

Patient sedated.

Area where the catheter will be sterilized and an incision will be made.

With image guidance. The catheter will be inserted.

Contrast Medium is injected, series of x-ray films are taken to locate the
abnormality.

Embolic agent is injected and additional x-rays are taken to make sure the
procedure is a success and loss of blood flow in the abnormality is confirmed.

Catheter is removed, and pressure is applied to stop bleeding and the opening is
covered with dressing.