How does embolization work?
Tumours in the head and neck area and along the spine are usually embolized using catheters that are inserted via the groin or arm and penetrate the arterial blood vessels to the tumour where the embolization agent is deposited. 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 an X-ray and contrast medium. This provides the doctor with a map of the blood vessels of the head/neck or spine and allows him or her to assess whether embolization is indicated as a treatment. If the decision is positive, a micro-catheter is inserted with the help of the X-ray image, which can also be used to navigate fine vessels. After performing a microangiography of the tumour region and clarifying the safety of the embolization, the interventionist introduces embolization agents through the microcatheter into the blood vessels of the tumour.
The vessel is often closed with the help of liquid embolization agents (glue, n-butyl cyanoacrylate, onyx, squid). Sometimes, however, plastic particles (polyvinyl alcohol) or platinum coils (detachable coils) are also used to reduce the tumor’s blood supply.
When is an embolism used?
Embolization of vascular tumors in the head, neck and spine is an important complement to surgical treatment. Since tumours inside the brain and spinal cord are difficult or impossible to remove, embolization is often performed before surgery or chemotherapy. It reduces the size of the tumour, thus improving the effectiveness of the treatment and minimizing the risk of complications. If performed before an operation, it simplifies tumor removal, for example, and reduces blood loss during the operation.
In patients for whom surgery is not possible, embolization can also be performed alone for certain tumours (e.g. paragangliomas, juvenile nasopharyngeal angiofibromas, hemangioblastomas). Embolization slows tumour growth, shrinks the tumour and reduces the pressure it exerts on the brain or spinal cord. This all helps to improve the pain and symptoms caused by the tumor.
For which diseases do we use embolization?
Common tumours of the head, neck and spine for which embolization makes sense:
- Juvenile nasal angiofibromas
- Aneurysmal bone cysts
- Paragangliomas (carotid body, glomus vagale, glomus jugulare),
- Vascular metastases of renal cell and 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, 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 Clinic for 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.
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.
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.
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 which you can get out of bed.
On the following day, a magnetic resonance examination is performed to assess the results of the operation and rule out 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 further procedure, check-up and consultation appointments are also agreed.
|3 – 4 days