Embolization and its Limits: Tips and Tricks

Abstract

Nowadays, the non-operative management is the preferred strategy, when possible. During the last years, improvement in embolic techniques and agents, make feasible and effective more conditions.
 In the present paper current indications, technical requirements, advantages and disadvantages, contraindications are discussed. Moreover particular attention is given to the limits of the embolization procedure, suggesting some tips documented by literature data to overcome these limits. The most feared limit/complication is the risk of non-target embolization, especially when target tissues are noble organs.
 Skilled interventional radiologists, inserted in an adequate multi-disciplinary team, have available tricks to limit risks, complications and failures.

Embolic Pneumonectomy for the Treatment of Proximal Pulmonary Artery Pseudoaneurysm

“…This technique involves the placement of malleable metal coils into the vascular sac until stasis is achieved. The placement of these coils functions to decrease blood flow, produce thrombosis, and encourage inflammation within the targeted space [ 10 , 11 ]. Our biggest barrier to attempting coil embolization was whether the patient could tolerate losing blood supply to his left lung as the pseudoaneurysm was located at the main left pulmonary artery.…”

A narrative review on pulmonary metastases management by non-surgical local techniques: where do we stand?

“…Alternative treatments have traditionally been reserved for poor surgical candidates or for patients who refuse surgery. In recent years, constant improvements and refinements in technology and more precise treatment strategies are widening the indications for these methods: curative intent, chemo-vacations and, more recently, treating metastases that present a dissociated or disproportional response to chemotherapy or new generation therapies represent the three widespread indications (67)(68)(69). In addition, ablation or radiotherapy may be considered an option for patients who present with ipsilateral metastases after prior metastasectomy (4).…”

Successful angioembolization with autologous subcutaneous fat in an open book pelvic fracture

“…By contrast, the Gelfoam is rather cheap with a quick, nonselective bleeding control profile, which makes it a reasonable choice for embolization, particularly in an emergency setting. [ 7 ] However, Gelfoam allows only temporary hemorrhage control and has a higher rate of rebleeding than permanently embolizing agents. [ 8 ]…”