Embolization of Brain Tumors
Embolization of hypervascularized brain and head and neck tumors has become an important adjunct to the surgical treatment of these tumors.
The procedure results in reduced morbidity and mortality, and facilitates the surgical removal of many of these tumors.
In tumors that are not amenable to surgical treatment, embolization may occasionally be used as the primary mode of treatment.
- Headache;
- Blurred and blurry vision;
- Seizures;
- Nausea and vomiting for no apparent reason;
- Lack of balance;
- Changes in mood and behavior;
- Numbness, tingling or weakness in a part of the body;
- Excessive sleepiness.
Indications for embolization include the following:
- Control surgically inaccessible arterial feeders;
- Decrease surgical morbidity by reducing blood loss;
- Shorten the time of the operative procedure;
- Increase the chances of complete surgical resection;
- Decrease the risk of damage to adjacent normal tissue;
- Allow a better visualization of the surgical field, with an overall decrease in surgical complications.
Embolization of nervous system tumors is a minimally invasive technique where it is not necessary to open the patient’s skull to treat the lesion.
The surgery is performed endovascularly, that is, inside the arteries and veins. For this, it is necessary to perform a puncture of an artery in the patient’s leg, at the level of the groin (femoral artery) or in the arm (radial or brachial artery) and take a microcatheter to the region of the lesion and then perform its occlusion of the arteries. that irrigate the tumor.
To perform the occlusion of the arteries that irrigate the tumor, we use embolic agents (glue or particles) that will fill the arteries and nourish the tumor, leading to a devascularization of the lesion and, therefore, facilitating the subsequent open surgical approach to remove the tumor.
There are several types of embolic agents that are capable of leading to a reduction or interruption of brain tumor circulation. The choice of the most appropriate material will depend on the characteristics of the lesion, the patient and the type of surgery that will be performed later, therefore, the choice of the best embolization technique is individualized. No surgical incision is needed, just a small hole in the skin that doesn’t need special dressings.
Which tumors can be embolized?
Several types of brain and head and neck tumors are hypervascular and therefore amenable to preoperative embolization to decrease blood loss during surgery and to increase the rate of maximal lesion resection.
The most commonly embolized tumors are meningiomas, hemagioblastomas, nasoangiofibromas, jugular glomus and hemagiomas.
How is embolization performed?
Embolization is performed by occluding the arteries that supply the tumor with a liquid embolizing agent (a kind of glue) or solid embolic agent (particles). These embolic agents are injected through small catheters (microcatheters) that are inserted into the arteries of the patient’s leg (femoral artery) or arm (radial or brachial artery) and taken by the endovascular neurosurgeon or interventional neuroradiologist to the level of the tumor.
What type of anesthesia is needed for embolization of brain and head and neck tumors?
Embolization of brain and head and neck tumors is performed under general anesthesia.
Are there any risks related to the procedure?
Every medical procedure has some risks. However, in general, the interventional methods are those with the lowest rates of complications.
Of the possible risks, the main ones are observed at the puncture site in the groin or wrist, such as a hematoma.
More serious complications such as cerebral ischemia, visual loss and cerebral hemorrhage can occur but are very rare events.
