How does embolization work?
Tumors in the head and neck region and along the spine are usually treated with embolization using catheters that are inserted through the groin or the arm and advanced through the arteries to the tumor, where the embolization agent is delivered through them. However, embolization performed directly through the skin can be a useful alternative.
After the catheter has been inserted, a cerebral or spinal angiogram is performed using X-rays and contrast dye. This provides the doctor with a map of the blood vessels in the head, neck, or spine, allowing him or her to assess whether embolization is an appropriate treatment. If the decision is positive, a microcatheter is inserted with the aid of an X-ray image, allowing even the finest vessels to be navigated. After performing microangiography of the tumor region and confirming the safety of the embolization procedure, the interventional radiologist injects the embolization agent through the microcatheter into the tumor’s blood vessels.
The vessel is often occluded using liquid embolization agents (adhesive, n-butyl cyanoacrylate, Onyx, Squid). However, plastic particles (polyvinyl alcohol) or platinum coils (detachable coils) are sometimes used to reduce the blood supply to the tumor.
When is embolization used?
Embolization of vascular tumors in the head, neck, and spine is an important adjunct to surgical treatment. Since tumors inside the brain and spinal cord are difficult or impossible to remove, embolization is often performed before surgery or before chemotherapy. It shrinks the tumor, thereby improving the effectiveness of the treatment and minimizing the risk of complications. If it is performed before surgery, it simplifies, for example, tumor removal and reduces blood loss during the operation.
For patients who are not candidates for surgery, embolization can also be performed as a standalone treatment for certain tumors (e.g., paragangliomas, juvenile nasopharyngeal angiofibromas, hemangioblastomas). Embolization slows tumor growth in that area, shrinks the tumor, and reduces the pressure it exerts on the brain or spinal cord. All of this helps alleviate the pain and symptoms caused by the tumor.
For which diseases do we use embolization?
Common tumors of the head, neck, and spine for which embolization is recommended:
- Meningiomas
- Hemangiopericytomas
- Juvenile Nasal Angiofibromas
- Hemangioblastomas
- Aneurysmal Bone Cysts
- Paragangliomas (carotid body, glomus vagale, glomus jugulare),
- Vascular metastases of renal cell carcinoma, thyroid carcinoma, melanoma (malignant melanoma), and choriocarcinoma.
Why choose the USZ?
Many years of expertise
Our clinic is an internationally renowned institution known for its expertise in diagnostics and minimally invasive, image-guided treatment. We treat diseases of the brain, the spinal cord, the peripheral nervous system and its associated organs (eyes, hearing and balance organs, etc.) and the surrounding structures on the head, neck and spine. We work closely with the Department of Ear, Nose, Throat, and Facial Surgery.
The latest treatment methods
At the Department of Neuroradiology, we use the most modern interventional methods, the most advanced materials and instruments and the latest imaging techniques. This enables us to offer every patient the best possible treatment.
Partner network
In weekly interdisciplinary conferences with experts from neurosurgery, neurology and neuroradiology, we develop an individual treatment concept for each case, which we then discuss with our patients. To ensure optimal therapeutic success, our international team of experienced neuroradiological interventionists works closely with experts from other highly specialized clinics as well as with outstanding nursing and rehabilitation specialists before, during and after the procedure.
Procedure
The first step is to make a diagnosis, decide on minimally invasive treatment and discuss it with you during the consultation. This is followed by a prompt treatment appointment, taking into account the urgency of the treatment and your specific wishes.
The hospital stay for the treatment lasts three to four days. You will arrive the morning before the procedure and we will assess the current findings and make the final preparations. We will be happy to answer any final questions. On the day of the procedure, you will be taken from the ward to one of our two operating theaters, where the surgical team will welcome you and perform the procedure.
Embolization of a head, neck, brain or spinal tumour is usually performed under general anaesthetic. This is a minimally invasive procedure that is performed in a neurovascular catheterization unit. The tumor vessels are made visible with X-rays during the procedure.
Aftercare
Immediately after the procedure, you will be examined to make sure that everything went well. You will then be transferred to a specialized monitoring ward, where you will be cared for and monitored until the next day. You must stay in bed for the first six hours or so; after that, you can get out of bed.
The following day, an MRI scan will be performed to evaluate the outcome of the surgery and rule out any complications. Normally you will then return to the normal ward and after a further one or two days you will be able to go home after a specialist consultation. During this final consultation, the next steps, as well as follow-up and office hours appointments, will also be scheduled.
| Hospitalization |
3 – 4 days |
