The Common but Complicated Tool: Review of Embolic Materials for the Interventional Radiologist

Abstract

Embolization is an important and widely utilized technique in interventional radiology. There are a variety of different categories and individual products which can be utilized to perform embolization. Understanding the different classes of embolic agents, the important features of each of these classes including strengths and limitations, and the variation in individual products within the classes is critical for interventional radiologist to practice safely and effectively. This article reviews the different kinds of embolics and relays some of the pertinent physical and chemical properties of individual products which should be considered when determining which embolic to select for a given purpose.

Embolic Materials: Understanding the Ocean of Choices

“…The selection of the coil softness, size, and length plays an important role in the ability to densely pack the vessel and thus prevent recanalization. 1 10 Coils have many advantages including the ability to provide controlled and predictable embolization of a target vessel. This precise knowledge of embolization location can provide reassurance for providers and reduce complications, such as non-target ischemia, at times.…”

“…35 36 After delivery, the DEBs slowly release the “loaded” chemical into the target tissue. This function has been utilized in cancer therapy 1 but has theoretical applications in other areas as well.…”

“…1,5 This likely explains why there are greater than 50 different coils commercially available. 1 One important aspect of coils to understand is that they rely on thrombosis to completely occlude the vessel. [5][6][7] Therefore, it is beneficial for the materials that make up coils to have thrombogenic properties, an area of evolution over the years.…”

“…[1][2][3][4] The technique has continued to evolve and find new areas of clinical use, with current indications ranging from the treatment of benign and malignant tumors, acute trauma, and chronic pain. [1][2][3][4] Given the wide variety of clinical applications, it is not surprising that there is also a wide variety of materials available for the interventionalist to utilize for any embolization procedure. 1 Furthermore, there has been consistent evolution of these products, which continues at present.…”

“…[1][2][3][4] Given the wide variety of clinical applications, it is not surprising that there is also a wide variety of materials available for the interventionalist to utilize for any embolization procedure. 1 Furthermore, there has been consistent evolution of these products, which continues at present. Knowledge of these materials as well as the strengths and weaknesses of each is paramount to allow the treating physician to achieve favorable results.…”