Embolization

+91-9313828405

Embolization

Introduction

Embolization is a way of occluding blood vessels and is usually performed for patients who experience excessive or prolonged bleeding.
It is a minimally invasive procedure done with skin incision of less than 5 mm.
8 out of 10 procedures are done under local anaesthesia, thus avoiding the inherent risk of general anaesthesia.
It is highly beneficial in critically ill, cardiac and unstable patients.
It is often a less invasive option than traditional surgical procedures with better patient outcomes.

Procedure

Embolization is performed by placing a small catheter inside the blood vessels that supply the area that is bleeding. Carefully navigating the catheter, under image guidance (X-ray), to the safest and farthest point, a variety of different materials can then be used to block the bleeding vessels. Materials include liquid tissue adhesives (glues), micro-coils or polyvinyl alcohol (PVA)particles. Embolization therapy can be performed in conjunction with other surgical procedures depending upon the cause of bleeding.

Bronchial Artery Embolization for Hemoptysis

Bleeding in cough is also known as Hemoptysis.

Overview

Haemoptysis is the symptom of coughing up blood.
In clinical practice, hemoptysis is considered to be life-threatening when there has been approximately 150 mL of blood expectorated in a 24-hour period.
It is one of the most frightening medical emergencies for patient and physician.
Challenges:

1. Explosive clinical presentation.

2. MAJOR RISK

a. Impending asphyxiation (lungs drowned in own blood)

b. Airway obstruction

3. Need to respond quickly and appropriately.

Lungs have dual supply: Bronchial arteries and Pulmonary arteries. In most patients the bleeding originates from bronchial arteries (90%) rather than pulmonary arteries. CT angiography can help to suggest the source of bleeding.

Causes

Chronic inflammatory conditions: Tuberculosis (TB) being the most common in India.
Other causes are: Bronchiectasis, Lung abscess and lung cancer.

Bronchial Artery Embolization

1. First results of embolization published in 1973.

2. Today is the therapy of choice for massive hemoptysis.

3. The arteries supplying the disease lung is selectively cannulated and embolized to stop bleeding. Since lung has dual lung supply it just stops the bleed without any damage to the lung.

4. Successful immediate control 95%.

5. Complications :

Sequelae of bronchial artery occlusion (e.g., chest pain, fever, hemoptysis)
Inadvertent ectopic emboli.

6. Recurrence rate around 10% at one year. It may be caused by:

Recanalization of previously embolized artery
Revascularization through collateral circulation
Progression of basic lung disease