Embolization

Embolization is a minimally invasive procedure that involves the selective occlusion of a blood vessel by placing special materials — emboli — into its lumen.

This is an image-guided procedure most commonly performed using angiography. The main goal of embolization is to stop or significantly reduce blood flow in a specific area of a blood vessel to stop bleeding or to cut off the blood supply to a pathological formation (e.g., a tumor).

Techniques and Materials

Access to the target vessel is gained through a small puncture, usually in the femoral or radial artery. A thin catheter is inserted through this puncture and advanced to the target area under the image guidance. Once the catheter is precisely positioned, embolic agents are introduced through it.

The choice of material depends on the purpose, size, and location of the vessel:

• Coils. Metal (usually platinum) coils that twist when inserted into the vessel forming a clot and blocking the blood flow.
• Microspheres (particles). Small balls made of synthetic polymers that block small arteries; often used in tumor embolization.
• Liquid embolic agents. Special adhesive compositions or polymers that are injected in liquid form and harden inside the vessel creating a solid occlusion.

Clinical Significance

Embolization is an important alternative to traditional open surgery and has a wide range of applications in various fields of medicine.

Key areas of application:

• Neurosurgery. To exclude cerebral aneurysms and arteriovenous malformations from the blood flow preventing them from rupture.
• Oncology. To stop the blood supply to tumors (e.g., uterine fibroids, certain liver tumors) leading to their reduction. It is often combined with the administration of chemotherapy drugs (chemoembolization).
• Emergency medicine. To quickly stop severe internal bleeding (gastrointestinal, post-traumatic, postpartum).

The procedure helps to avoid large incisions, reduces hospitalization time and speeds up patients’ recovery. However, it is associated with certain risks such as unintentional blockage of healthy vessels (nontarget embolization) and the development of post-embolization syndrome (pain, fever).