Preoperative Embolization of Brain/Spine Tumours
What conditions does this treatment treat?
A spinal or brain tumour is a swelling or lump formed from the abnormal multiplication of cells. A tumour diagnosis can be scary, but not to worry, not all of them are cancerous. They can be benign (non-cancerous), or malignant (cancerous).
If recommended by your doctor, surgery can be used to remove brain tumours, to remove as much abnormal tissue as possible. Usually, benign tumours will not grow back once they’re removed, but in some cases, they do and might become cancerous. If all of the tumour cannot be removed in surgery, other treatments like chemotherapy may be used to destroy the remaining cells.
What is this treatment?
However, due to the location of these tumours in the head, neck and spine, they often tend to have a large blood supply that makes surgical removal risky and increases the complications of the resection surgery.
Thus, a preoperative embolisation procedure can be done before a surgery, in order to reduce the blood flow to these tumours. Embolisation decreases blood flow to the tumour through sealing off certain blood vessels supplying the tumour, and is usually performed a few days before the main surgery. This decreases the amount of bleeding that will happen when the main surgery is performed, reducing surgical risks and the need for blood transfusions, and also decreasing the duration of the surgery.
What is expected during this treatment?
You will be put under general anaesthesia by an anaesthesiologist. A small incision is made in the groin, in order to insert the catheter into your artery which supplies blood to the tumour. This means there will be no obvious surgical scar.
During the surgery, X-ray fluoroscopy will be used to guide the catheter towards the tumour. An angiogram is done by injecting contrast dye into your blood vessel to examine the blood flow towards the tumour and make sure it is safe to seal up that vessel. The interventional neurologist will position the catheter and different agents like metal coils, embolizing agents (small plastic particles) and glue-like substances are delivered through the catheter in order to help the blood vessels supplying the tumour to close up.
In some cases, especially with spinal tumours, a needle is directly inserted into the skin and down towards the tumour in the bone, and embolizing agents are directly injected to block off blood supply.
This procedure can be performed as an outpatient procedure, meaning you can return home within the day of the surgery and return to daily activities within the next 48 hours. Thus, this procedure is extremely safe.
What are some possible side effects or risks?
In general, this procedure is a very safe one, although complications and side-effects are always a possibility. Some possible surgical risks include allergic reactions to the injected material, as well as damage to the blood vessel and minor bruising or heavy bleeding at the site of the catheter insertion.
In some cases, re-embolisation might need to be done as the blood flow to the tumour is not successfully blocked off after the first procedure.
What do I do after I get this treatment?
After the preoperative embolisation procedure has been completed, you will probably need to return for a few check-ups before your main resection surgery for your brain or spinal tumour.
If you have any questions about this procedure, do seek clarification with your doctor and find out whether this treatment is suitable for you.
- Preoperative Embolization – Imaging Glossary – Patients – UR Medicine Imaging Sciences (Radiology) – University of Rochester Medical Center. (n.d.). Www.Urmc.Rochester.Edu. Retrieved December 22, 2020, from https://www.urmc.rochester.edu/imaging/specialties/procedures/preoperative-embolization.aspx#:~:text=When%20surgery%20is%20planned%2C%20a
- Pre-operative Tumor Embolization. (n.d.). Www.Emoryhealthcare.org. Retrieved December 22, 2020, from https://www.emoryhealthcare.org/radiology/pre-op-tumor-embolization.html
- Rilling, W. S., & Chen, G. W. (2004). Preoperative Embolization. Seminars in Interventional Radiology, 21(1), 3–9. https://doi.org/10.1055/s-2004-831400