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Endovascular Embolisation.

Endovascular Embolisation is a minimally invasive procedure to treat abnormal blood vessels in the body. It can include one or more blood vessels, AV malformations or aneurysms in the body.

How is it done

During the procedure Fluoroscopy (real time X-ray) is used to guide a small catheter into the blood vessels. The catheter is then manoeuvered to the exact site of bleeding or abnormal vessel. Then Embolic agents (synthetic materials) are injected through a catheter into a blood vessel to prevent blood flow to the area and embolising the vessel.

Why do we Embolise

Endovascular Embolisation may be used as the sole treatment or combined with other treatments such as surgery or radiation.

It is used to

* Control or prevent abnormal bleeding resulting from injury, tumor, gastrointestinal tract lesions, diverticular disease or fibroid tumors.

* Occlude vessels supplying blood to a tumor. The tumor may be difficult to remove due to blood supply, by decreasing blood flow, the tumor may shrink or may decrease blood loss at surgery.

* Eliminate arteriovenous malformations (AVM) or arteriovenous fistula (AVF)

* Treat aneurysms

Benefits of Embolisation

* Embolisation is a highly effective way of controlling bleeding especially in an emergency situation

* Less invasive than open surgery

* Fewer complications

* Shorter hospital stays

* Decrease in blood loss

* Used to treat tumours, AVM's that can't be removed surgically or are a high risk of surgery

Some samples of embolic agents

Risks involved in Embolisation

* Allergic reaction to contrast medium

* Allergic reaction to embolic agent

* Damage to blood vessel wall

* Bruising or bleeding at puncture site

* Infection even if AB's are given

* Embolic agent being lodged in wrong vessel

* Kidney damage due to contrast medium especially patients with diabetes or pre-existing kidney disease

References:

Gandhi, D., Chen, J., Pearl, M. Huang, J., Gemmette, J.J., and Kathuria, S. (2012). Intracranial Dural Arteriovenous Fistulas: Classification, Imaging Findings, and Treatment. DOI: https://doi.org/10.3174/ajnr:A2798. Downloaded 12/09/2018.

Hoppe, Hanno, MD, EBIR, FCIRSE and Kos, Sebastian, MD, EBIR, FCIRSE. (2018). Splenic Artery Embolization: Proximal or Distal? https://evtoday.com/2018/04/splenic-artery-embolization-proximal-or-distal/. Downloaded 12/09/2018

Imbrogno, Brian F., MD and Ray, Charles E. Jr., MD, Ph.D., F.S.I.R. (2012). Splenic Artery Embolization in Blunt Trauma. https://www.ncbi.nim.nih.gov/pmc/articles/PMC3444871/. Downloaded 12/09/2018.

Luo, Chao-Bao, Chang, Feng-Chi, and Teng, Michael Mu-Huo. (2014). Update of embolization of intracranial dural arteriovenous fistula. https://www.sciencedirect.com/science/article/pii/S17226490114002329. Downloaded 12/09/2018.

Sopico, David R., M.D. and Smith, Tony P. (2011). Brronchial Artery Embolization for Hemoptysis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140255/. Downloaded 26/04/2018.

Stampfl, U., Radeleff, B., Sommer, C., Stampfl, S., Dahlke, A., Bellemann, N., Kauczor, HU. and Richter, G., M. (2011). CardioVascular and Interventional Radiology. Midterm Results of Uterine Artery Embolization Using Narrow-Size Calibrated Embozene Microspheres https://www.ncbi.nlm.nih.gov/pubmed/20953610. Downloaded 26/04/2018

Maribel Bolt RN, Victoria Whitta RN, Department of Radiology. Christchurch District Health Board. Christchurch New Zealand
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Title Annotation:medical imaging
Author:Bolt, Maribel
Publication:The Dissector: Journal of the Perioperative Nurses College of the New Zealand Nurses Organisation
Date:Mar 1, 2019
Words:503
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