How does embolization work?
We usually embolize tumors in the head and neck region and along the spine with catheters that we insert through an opening in the vessels of the groin or arm. The catheters advance via the arterial blood vessels to the tumor where they deposit the embolization agent. However, embolization performed directly through the skin can be a useful alternative.
After we have inserted the catheter, we perform a cerebral or spinal angiogram using X-ray and contrast medium. This map of the blood vessels of the head/neck or of the spine helps to determine whether embolization is the right treatment. If the decision is positive, we use the X-ray image to insert a micro-catheter, which can reach even fine vessels. After a micro-angiography of the tumor region and after a safety assessment, the interventionist then uses the micro-catheter to introduce embolization agents into the tumor’s blood vessels.
Vessels are often sealed with liquid embolization agents (glue, n-butyl cyanoacrylate, onyx, squid). However, sometimes plastic particles (polyvinyl alcohol) or platinum coils (detachable coils) are used to reduce the tumor’s blood supply.
When is embolization used?
Embolization of vascular tumors of the head, neck and spine is an important addition to surgical treatment. Because tumors inside the brain and spinal cord are difficult or impossible to remove, embolization is often performed before surgery or chemotherapy. The embolization shrinks the tumor and thus improves the effectiveness of subsequent interventions and minimizes their risk for complications. For example if embolization is performed before surgery, it simplifies tumor removal and reduces blood loss during the operation.
In patients where surgery is not possible, embolization can serve as a stand-alone treatment for certain tumors (e.g. paragangliomas, juvenile nasopharyngeal angiofibromas, hemangioblastomas). For these tumors, embolization slows tumor growth, shrinks the tumor and reduces the pressure it exerts on the brain or spinal cord. All this helps to improve the pain and symptoms caused by the tumor.
Which diseases can we treat with embolization?
Embolization is useful for the following common tumors of the head, neck and spine:
- Juvenile nasal angiofibromas
- Aneurysmal bone cysts
- Paragangliomas (carotid body, glomus vagale, glomus jugulare),
- Vascular metastases of renal cell carcinoma, thyroid carcinoma, melanoma and choriocarcinoma.
Why choose the USZ?
Many years of expertise
Our clinic is an internationally renowned institution in the field of diagnostics and minimally invasive, image-guided treatment. We treat diseases of the brain, spinal cord, peripheral nervous system, associated organs (eyes, auditory, vestibular, etc.), and surrounding structures of the head, neck and spine.
Latest treatment methods
At the Department of Neuroradiology, we strive to offer the best possible treatment to every patient. We therefore use the latest interventional methods, the most advanced materials and instruments, and cutting-edge imaging techniques.
Additionally, we hold weekly interdisciplinary conferences with experts from neurosurgery, neurology and neuroradiology during which we develop an individual therapy concept for each case. To guarantee optimal treatment selection and patient care our experienced neuroradiological interventionists further collaborate with experts from other clinics as well as with outstanding nursing and rehabilitation specialists before, during and after the intervention.
Course of treatment
Treatment starts with the diagnosis and the decision to use minimally invasive methods. After discussing this with you during a consultation, we will schedule a timely appointment, which is in keeping with the urgency of your case and your special wishes.
The treatment requires a hospital stay of three to four days. You will arrive the morning before the procedure and we will assess your current status and make the final preparations. We will use this opportunity to answer any questions you might have. On the day of the procedure, you will be taken from the ward to one of our two operating rooms, where the surgical team will meet you and the procedure is performed. Embolization for a head, neck, brain or spinal tumor is usually performed under general anesthesia. This minimally invasive procedure performed in a neurovascular catheterization unit and the tumor vessels are visualized with X-rays during the procedure.
Immediately after the procedure, we will examine you to make sure everything went well. We will then transfer you to a specialized monitoring ward where you will be cared for until the next day. You will need to stay in bed for the first approximately six hours. After that you will be able to move out of bed. On the following day, you will undergo a magnetic resonance examination to assess the surgical outcome and rule out any complications. Normally, you will then return to the standard ward and after another one or two days you will consult with a specialist and can then go home. During this last consultation, we will schedule appointments for further check-ups.