Release Date: 2024-06-10

Embolization Procedures in Oncological Patients

Mehmet Turmak (Author)

Release Date: 2024-06-10

Embolization is a vascular interventional procedure that employs various materials to obstruct the blood flow of a vessel or tumor. Embolization in oncologic patients serves a multitude of purposes, including the cessation of tumor or tissue blood flow by means of catheterization with various materials, the reduction of tumor size by creating ischemia through the [...]

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    Work TypeBook Chapter
    Published inThe Radiology of Cancer
    First Page569
    Last Page589
    DOIhttps://doi.org/10.69860/nobel.9786053359364.37
    Page Count21
    Copyright HolderNobel Tıp Kitabevleri
    Licensehttps://nobelpub.com/publish-with-us/copyright-and-licensing

    Embolization is a vascular interventional procedure that employs various materials to obstruct the blood flow of a vessel or tumor. Embolization in oncologic patients serves a multitude of purposes, including the cessation of tumor or tissue blood flow by means of catheterization with various materials, the reduction of tumor size by creating ischemia through the coverage of the most distal region, and the mitigation of bleeding risk during surgery by the administration of preoperatively in hypervascular tumors. It is of great importance that the embolization targets the distal bed, as proximal embolization may cause neovascularization at a later stage, which may ultimately lead to failure of the technically correct procedure. Therefore, the choice of embolizing particles is a crucial step. The use of too large particles may result in proximal occlusion, whereas the use of too small particles may lead to mucosal necrosis, chronic pain, or unwanted tissue and/or organ embolization via microcollaterals. In this chapter, our objective is to provide a concise overview of embolizing agents and subsequently discuss embolization procedures in head and neck, renal, pelvic-gynecological, and bone tumors, respectively.

    Mehmet Turmak (Author)
    Assistant Professor, Dicle University
    https://orcid.org/0000-0002-2278-4729
    3Asst. Professor Dr. Mehmet TURMAK graduated from the Faculty of Medicine at Ege University in 2008. He then proceeded to the Department of Radiology at Dicle University, where he graduated in 2009. In 2013, he successfully completed his thesis on traumatic diaphragmatic hernias and was awarded the title of Radiology Specialist. After gaining experience in various hospitals, he commenced his role as Asst. Professor in the Department of Radiology at Dicle University Faculty of Medicine in 2021. He continues to work in this department, particularly in the field of interventional radiology.

    • Rosch j, Dotter CT, Brown Mj. selective arterial embolization. A new method for control of acute gastrointestinal bleeding. Radiology. 1972;102(2):303-6.

    • Dawbarn RHM. The starvation operation for malignancy in the external carotid area. jAMA. 1904;116:792-5.

    • Luessenhop A, spence W. Artificial embolization of cerebral arteries: report of use in a case of arteriovenous malformation. jAMA. 1960;172: 1153-5.

    • Londoño MA, Vallejo AD, Argueta LF, uribe jR, jaramillo AR. Transcatheter Embolization. Rev. Colomb. Radiol. 2017;28:4773-81.

    • Yamada R, nakatsuka H, nakamura K, sato M, Tamaoka K, Takemoto K, et al. [super-selective arterial embolization in unresectable hepatomas (author’s transl)]. nihon ıgaku Hoshasen Gakkai zasshi. 1979;39(5):540-3.

    • Borges A, Ramalho S, Ferreira l. Common carotid artery trifurcation: a potentially dangerous anatomical variant. bmJ case rep 2021;14. DoI: 10.1136/bcr-2020-241104.

    • Esmaeil S, Eltatawy A, Abbasi MH, et al. e-224, Bilateral external carotidbartery sacrifice in massive refractory hemorrhage of the pharynx: a case report. In.: british medical Journal publishing Group, 2022.

    • Sarafoleanu C, Bejenariu A, Enache R, et al. Functional recovery afternsurgical approach of jugulotympanic glomus tumors. romanian Journal of rhinology 2022;12:102-14. DoI: 10.2478/rjr-2022-0016.

    • Medsinge A, Zajko A, Orons P, Amesur N, Santos E. A case-based approach to common embolization agents used in vascular interventional radiology. AjR Am j Roentgenol. 2014;203(4):699-708.

    • Gruber A, Bavinzski G, Killer M, et al. Preoperative embolization of hypervascular skull base tumors. minim Invasive neurosurg. 2000 jun;43(2):62-71.

    • Yamamoto T, Ohshima T, Nishihori M, et al. Preoperative embolization of meningiomas with low-concentration n-butyl cyanoacrylate. nagoya j med sci. 2015;77(3):347-53

    • Avritscher R, Wallace Mj. Principles of embolization. ın: Mueller PR, Adams A, eds. ınterventional Oncology: A Practical Guide for the ınterventional Radiologist. new York: springer; 2012. p.81-6.

    • Bonnemain B. History of Contrast Media: Celebrating the Centenary of the use of Lipiodol [R] in Radiology. Erciyes Medical journal. 2021;43(6):626-31.

    • Vaidya s, Tozer KR, Chen j. An overview of embolic agents. semin ıntervent Radiol. 2008;25(3):204-15.

    • Nakamura H, Tanaka T, Hori S, et al. Transcatheter embolization of hepatocellular carcinoma: assessment of efficacy in cases of resection following embolization. Radiology. 1983;147(2):401-5.

    • Park jH, Chung jW. Principles of Embolization. ınterventional Oncology; 2008. p.67-77.

    • de Baere T, Arai Y, Lencioni R, et al. Treatment of Liver Tumors with Lipiodol TACE: Technical Recommendations from Experts Opinion. Cardiovasc ıntervent Radiol. 2016;39(3):334-43.

    • Lencioni R, Llovet jM. Modified RECısT (mRECısT) assessment for hepatocellular carcinoma. semin Liver Dis. 2010;30(1):52-60.

    • Lucatelli P, Burrel M, Guiu B, et al. CıRsE standards of Practice on Hepatic Transarterial Chemoembolisation. Cardiovasc ıntervent Radiol. 2021;44(12):1851-67.

    • Reinders MTM, Smits MLj, van Roekel C, et al. Holmium-166 Microsphere Radioembolization of Hepatic Malignancies. semin nucl Med. 2019;49(3):237-43.

    • d’Abadie P, Hesse M, Louppe A, et al. Microspheres used in liver radioembolization: from conception to clinical effects. Molecules. 2021;26(13):3966.

    • Iezzi R, Pompili M, Rinninella E, et al. TACE with degradable starch microspheres (DsM-TACE) as second-line treatment in HCC patients dismissing or ineligible for sorafenib. Eur Radiol. 2019;29(3):128592.

    • Sharafuddin Mj, Sun S, Golzarian J. Embolotherapy: basic principles and applications. ın: Vascular embolotherapy, springer, Berlin, Heidelberg; 2006. p.3-13.

    • Lubarsky M, Ray CE, Funaki B. Embolization agents-which one should be used when? Part 1: large-vessel embolization. semin ıntervent Radiol. 2009;26(4):352-7.

    • Emanuelli E, o’Connor M, Garg rK. Management of a Highly vascular low-grade myofibroblastic sarcoma of the mandible. Plast reconstr surg Glob open. 2022;10(1):e4043.

    • Dean B L, Flom R A, Wallace R C et al. Efficacy of endovascular treatment of meningiomas: evaluation with matched samples. AJNR Am J Neuroradiol. 1994;15(09):1675–1680. [PMC free article] [PubMed] [Google Scholar]

    • Macpherson P. The value of pre-operative embolisation of meningioma estimated subjectively and objectively. Neuroradiology. 1991;33(04):334–337. [PubMed] [Google Scholar]

    • Moulin G, Chagnaud C, Gras R et al. Juvenile nasopharyngeal angiofibroma: comparison of blood loss during removal in embolized group versus nonembolized group. Cardiovasc Intervent Radiol. 1995;18(03):158–161.

    • Duffis EJ, Gandhi CD, Prestigiacomo CJ, et al; Society for neurointerventional surgery. Head, neck, and brain tumor embolization guidelines. j neurointerv surg. 2012;4(4):2515.

    • Jindal G, Gemmete J, Gandhi D. Interventional neuroradiology applications in otolaryngology, head and neck surgery. otolaryngol Clin north am. 2012;45(6):1423-49.

    • Lasjaunias P, Ter Brugge KG, Berenstein A. Surgical neuroangiography: vol. 3: clinical and interventional aspects in children. Springer Science & business media, 2007.

    • Mann WJ, Jecker P, Amedee RG. Juvenile angiofibromas: changing surgical concept over the last 20 years. laryngoscope 2004;114:291-3. DoI: 10.1097/00005537-200402000-00020.

    • Osborn aGJm. Diagnostic neuroradiology. 1994.

    • Gandhi D, Gemmete JJ, Ansari SA, et al; Interventional neuroradiology of the head and neck. ajnr am j neuroradiol. 2008;29(10):1806-15.

    • Geibprasert S, Pongpech S, Armstrong D, et al. Dangerous extracranial-intracranial anastomoses and supply to the cranial nerves: vessels the neurointerventionalist needs to know. ajnr am j neuroradiol. 2009;30(8):1459-68.

    • Lazzaro MA, Badruddin A, Zaidat OO, et al; Endovascular embolization of head and neck tumors. Front neurol. 2011;2:64.

    • Thiex R, Wu I, Mulliken JB, et al; Safety and clinical efficacy of onyx for embolization of extracranial head and neck vascular anomalies. ajnr am j neuroradiol. 2011;32(6):10826.

    • Gobin YP, Murayama Y, Milanese K, et al. Head and neck hypervascular lesions: embolization with ethylene vinyl alcohol copolymer--laboratory evaluation in swine and clinical evaluation in humans. radiology. 2001;221(2):309-17.

    • Minion DJ, Lynch TG, Baxter BT, et al; Pseudoaneurysm of the external carotid artery following radical neck dissection and irradiation: a case report and review of the literature. Cardiovasc surg. 1994;2(5):60711.

    • Karydes HC, Bailitz JM. An unusual case of epistaxis-juvenile nasopharyngeal angiofibroma. j emerg med. 2012;43(4):e231-3.

    • Morrissey DD, Andersen PE, Nesbit GM, et al; endovascular management of hemorrhage in patients with head and neck cancer. arch otolaryngol Head neck surg. 1997;123(1):15-9.

    • Sesterhenn Am, Iwinska-Zelder J, Dalchow CV, et al; Acute haemorrhage in patients with advanced head and neck cancer: value of endovascular therapy as palliative treatment option. j laryngol otol. 2006;120(2):117-24.

    • Shah H, Gemmete JJ, Chaudhary N, et al; Acute lifethreatening hemorrhage in patients with head and neck cancer presenting with carotid blowout syndrome: follow-up results after initial hemostasis with covered-stent placement. ajnr am j neuroradiol. 2011;32(4):743-7.

    • Chen YF, Lo YC, Lin WC, et al. Transarterial embolization for control of bleeding in patients with head and neck cancer. otolaryngol Head neck surg. 2010;142(1):90-4.

    • Maran AG, Amin M, Wilson JA. Radical neck dissection: a 19-year experience. j laryngol otol. 1989;103(8):760-4.

    • Borsanyi SJ. Rupture of the carotids following radical neck surgery in radiated patients. eye ear nose Throat mon. 1962;41:531-3.

    • Citardi MJ, Chaloupka JC, Son YH, et al; Management of carotid artery rupture by monitored endovascular therapeutic occlusion (1988-1994). laryngoscope. 1995;105(10):1086-92.

    • Chaloupka JC, Roth TC, Putman CM, et al; recurrent carotid blowout syndrome: diagnostic and therapeutic challenges in a newly recognized subgroup of patients. ajnr am j neuroradiol. 1999;20(6):1069-77.

    • 49. Chang FC, Luo CB, Lirng JF, et al; Complications of carotid blowout syndrome in patients with head and neck cancers treated by covered stents. Interv neuroradiol. 2008;14 suppl 2(suppl 2):29-33.

    • Nelson CP, Sanda MG. Contemporary diagnosis and management of renal angiomyolipoma. J Urol 2002;168:1315-1325. DoI: 10.1097/01.ju.0000028200.86216.b2.

    • Linehan WmJp, Oncology PO. Cancer of the kidney and ureter. 1989. DoI: 10.11252/dobutsurinshoigaku.9.19.

    • Craven WM, Redmond PL, Kumpe DA, et al; Planned delayed nephrectomy after ethanol embolization of renal carcinoma. J Urol 1991;146:704-8. DoI: 10.1016/s0022-5347(17)37899-0

    • Klimberg I, Hunter P, Hawkins IF, et al; Preoperative angioinfarction of localized renal cell carcinoma Using absolute ethanol. Journal of Urology 1985;133:21-4. DoI: 10.1016/s0022-5347(17)48768-4.

    • Jacobs JA, Ring EJ, Wein AJ. New indications for renal infarction. J Urol 1981;125:243-5. DoI: 10.1016/ s0022-5347(17)54988-5.radiol.2243011513.

    • Nurmi M, Satokari K, Puntala P. Renal artery embolization in the palliative treatment of renal adenocarcinoma. Scand J Urol Nephrol 1987;21:93-6. DoI: 10.3109/00365598709180300.

    • Kjerulff KH, Langenberg PW, Rhodes JC, et al; Effectiveness of hysterectomy. obstet Gynecol 2000;95:319. DoI: 10.1016/s0029-7844(99)00544-x.

    • Farrer-BROWN G, Beilby J, Tarbit MJO, et al; Venous changes in the endometrium of myomatous uteri. 1971;38:743-51.

    • Folkman JJmm. Angiogenesis inhibitors generated by tumors. 1995;1:120-122. DoI: 1076-1551/95/$10.50/0.

    • Chavez NF, Stewart eaJco, Gynecology. Medical treatment of uterine fibroids. 2001;44:372-84.

    • Heaston DK, Mineau DE, Brown BJ, et al. Transcatheter arterial embolization for control of persistent massive puerperal hemorrhage after bilateral surgical hypogastric artery ligation. 1979;133:152-4.

    • Oliver JA. Selective embolization to control massive hemorrhage following pelvic surgery. 1979.

    • Nikolic B, Spies JB, Abbara S, et al; Ovarian artery Supply of Uterine Fibroids as a cause of Treatment Failure after Uterine artery embolization: a case report. Journal of Vascular and Interventional radiology 1999;10:1167-70. DoI: 10.1016/s1051-0443(99)70215-0.

    • Razavi MK, Hwang G, Jahed A, et al; Abdominal myomectomy versus uterine fibroid embolization in the treatment of symptomatic uterine leiomyomas. aJr am J roentgenol 2003;180:1571-5. DoI: 10.2214/ ajr.180.6.1801571.

    • Razavi MK, Wolanske KA, Hwang Gl, et al; Angiographic classification of ovarian artery-to-uterine artery anastomoses: initial observations in uterine fibroid embolization. radiology 2002;224:707-12. DoI: 10.1148/

    • Bowers TA, Murray JA, Charnsangavej C, et al; Bone metastases from renal carcinoma: the pre-operative use of transcatheter arterial occlusion. J Bone Joint surg Am. 1982;64:749-54.

    • Sun S, İang EV. Bone metastases fom renal cell carcinoma: preoperative embolization. J vasc Interv Radiol. 1998;9:263-9.

    • Roscoe MW, McBroom RJ, st. Louis E, et al; Preoperative embolization in the treatment of osseous metastases from renal cell carcinoma. Clin orthop. 1989;238:302-7.

    • Feldman F, Caserella WJ, Dick HM, et al; Selective intraarterial embolization of bone tumors: a useful adjunct in the management of selected lesions. AmJ Roentgenol Radium Ther Nucl Med. 1975;123:130-9.

    • Yakes WFJ, Carrasco CH, Luethke JM. Embolization of lumbosacral lesions, in Doty JR, Rengachary ss (eds): surgical Disorders of the sacrum. New york: Thieme, 1994. p. 294-308.

    • Hess T, Kramann B, Schmidt E, et al; Use of preoperative vascular embolisation in spinal metastasis resection. Arch orthop Trauma surg. 1997;116:279-82.

    • Gellad FE, Sadato N, Numaguchi Y, et al; Vascular metastatic lesions of the spine: preoperative embolization. Radiology.1990;176:683-6. 5.

    • Konya A, Szendroi M. Aneurysmal bone cysts treated by superselective embolization. skeletal Radiol. 1992;21:167-72.

    • Prabhu VC, Bilsky MH, Jambhekar K, et al. Results of preoperative embolization for metastatic spinal neoplasms. J Neurosurg (spine 2). 2003;98:156-64.

    • Hi HB, Suh DC, Lee HK, et al; Preoperative transarterial embolization of spinal tumor: embolization techniques and results. AJNR.1999; 20:20091

    • Kickuth R, Waldherr C, Hoppe H, et al; Interventional Management of Hypervascular Osseous Metastasis: Role of Embolotherapy Before Orthopedic Tumor Resection and Bone stabilization. AJR Am. J. Roentgenol. 2008;191(6):240-7.

    • Sgalambro F, Zugaro L, Bruno F, et al. Interventional Radiology in the Management of Metastases and Bone Tumors. J Clin Med. 2022;11(12):3265.

    • Mavrogenis AF, Rossi G, Rimondi E, et al; Embolization of bone tumors. Orthopedics. 2011;34(4):303-10.

    • Smith TP, Gray l, Weinstein JN, et al; Preoperative transarterial embolization of spinal column neoplasms. J vasc Interv Radiol.1995;6:8639.

    • Sung HW, Shu WP, Wang HM, et al. Surgical treatment of primary tumors of the sacrum. Clin orthop. 1987;215:91-8.

    • Lackman RD, Khoury lD, Esmail A, et al. The treatment of sacral giantcell tumours by serial arterial embolisation. J Bone Joint surg Br.2002; 84:873-7 Pogoda P, Linhart W, Priemel M, et al. Aneurysmal bone cysts of the sacrum. Clinical report and review of the literature. Arch orthop Trauma surg.2003;123:24751.

    • Pogoda P, Linhart W, Priemel M, et al. Aneurysmal bone cysts of the sacrum. Clinical report and review of the literature. Arch orthop Trauma surg.2003;123:247-51.

    • Dick HM, Bigliani lu, Michelsen WJ, et al. Adjuvant arterial embolization in the treatment of benign primary bone tumors in children. Clin orthop. 1979;139:133-41.

    • Eftekhari F, Wallace S, Chuang VP, et al. Intraarterial management of giant-cell tumors of the spine in children. pediatr Radiol.1982;12:289-93.

    • De Cristofaro R, Biagini R, Boriani s, et al. selective arterial embolization in the treatment of aneurysmal bone cyst and angioma of bone. skeletal Radiol.1992;21:523-7.

    • Stecken J, Bardaxoglou E, Touquet S, et al. [Giant sacral schwannoma with pelvic extension. Therapeutic strategy. Apropos of a case.] Neurochirurgie. 1996;42:294-9.

    • Winants D, Bertal A, Hennequin l, et al. [Imaging of cervical and thoracic chordoma. Apropos of 2 cases.] J Radiol.1992;73:169-74.

    • Varma J, Huben RP, Wajsman Z, et al. Therapeutic embolization of pelvic metastases of renal cell carcinoma. J Urol. 1984;131(4):647-9.

    • Hemingway AP, Allison DJ. Complications of embolization: analysis of 410 procedures. Radiology. 1988;166(3):669-72.

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