Tumors in the head, neck and spinal cord can be difficult to remove surgically because they are so close to vital structures or can lead to a large amount of bleeding. Sometimes, embolizing a tumor before surgery can reduce blood loss during surgery and improve patient outcomes. Tumor embolization helps block blood flow to the tumor—allowing for safer, quicker tumor removal. In cases where surgery is not possible, tumor embolization can sometimes reduce symptoms and improve patients’ quality of life (palliative care).
What happens during tumor embolization?
Before the procedure, you will have met with your neurointerventionalist in an office visit and discussed the procedure and its risks and benefits.
Prior to your procedure, we’ll take you to a preparation area where our nurses will start an IV in your arm and give you any medication that may be required prior to your procedure. We may give you medicines to protect your kidneys, antibiotics to help prevent infection, and anti-nausea medications. You may have a Foley catheter (tube) placed into your bladder.
We sometimes use general anesthesia, so you may not be aware of the remainder of the procedure. For some patients, we use conscious sedation or mild anesthesia in which you remain slightly awake. We will monitor your pulse, blood pressure, and your breathing throughout the procedure.
We’ll take you to a special room similar to an operating room. During your tumor embolization procedure, you’ll lie on your back on a table and we’ll clean the area where the catheter (a thin, hollow tube) will enter your body using a special solution to minimize infection. We’ll place sterile drapes over your body and the neurointerventionalist will apply a local anesthetic so you don’t feel any pain.
Your neurointerventionalist will make a small incision in your groin or upper thigh to insert the catheter and, using imaging techniques, will navigate the catheter to the blood vessels near the lesion. We will begin with an angiogram (blood vessel pictures) to map the blood vessels that are feeding the tumor. We will only treat those blood vessels feeding the tumor and avoid those that go to the brain. A tiny microcatheter will carefully be advanced into the blood vessels feeding the tumor and we’ll carefully administer tiny little particles (plastic beads) specially designed to block these blood vessels. After the procedure, we may take additional angiograms to be sure we treated as much of the tumor as possible.
After your procedure, your neurointerventionalist will review the results of your embolization with you and your physician (neurosurgeon) so he or she can discuss the next steps with you.