Tumor Embolization | Vascular Neurology of Southern California
Tumors form when normal, healthy cells are subjected to errors or mutations in their DNA. These mutations result in cells growing and dividing at increased rates, and this cycle continues beyond when healthy cells would usually die. As a result, this type of mutation creates a mass of atypical cells, which form a tumor.
Apart from the brain itself, tissues close to it, such as the brain-covering membranes (meninges), cranial nerves, the pituitary gland or pineal gland, can also be affected by tumors.
Tumors located in any of these areas can bleed heavily during surgery, making the neurointerventionalist’s task very difficult, if not impossible.
What is Tumor Embolization?
Because performing tumor removal surgery may cause bleeding, performing an embolization (the planned blockage of the blood supply) is vital. A successful embolization makes surgically removing the tumor much easier.
With an embolization, the surgeon encounters significantly less bleeding while removing the tumor. In turn, this reduces the need for blood transfusions and typically shortens the duration of the tumor removal procedure itself.
A secondary benefit from embolization is that, with the blood supply removed, the tumor margins become more easily identifiable, which means the tumor can be removed more completely and with less risk and effort.
In short, tumor embolization shuts down the blood supply to a tumor, thus reducing blood loss during surgical resection.
Tumors occurring in both the head and spine that may benefit from embolization include paragangliomas, meningiomas, head and neck tumors, and bone tumors of the spine.
As a triple-board certified neurointerventionalist, Dr. M. Asif Taqi has extensive training and advanced expertise in tumor embolization and removal. As a result, he has earned the reputation of being among California’s most respected neurointerventionalists.
If you want to learn more about Dr. Taqi and how he can help you prevent neurological disorders, Contact his team today to arrange your consultation in Thousand Oaks or West Hills, CA.
The Tumor Embolization Process
Before undergoing a tumor embolization and, ultimately, the removal of the tumor itself, the patient may want to learn more about the entire process.
Cerebral or spinal angiogram
Before carrying out a tumor embolization, and depending on the location of the tumor, it might be necessary to perform a cerebral or spinal angiogram.
Obtained by injecting X-ray contrast dye via a small-tubed catheter into the blood supply to the tumor, the dye deployed during the angiogram moves through the blood vessels, and a special camera or fluoroscope captures images of the blood vessels.
This dye provides a roadmap of the blood vessels of the tumor in the brain or spine. With the blood vessels mapped, the neurointerventionalist can determine how the tumor is supplied with blood and whether the blood supply is amenable to embolization treatment.
Some patients may require additional imaging such as that provided by an MRI (magnetic resonance imaging) or a CT (computerized tomography or CAT scan) to confirm the diagnosis of their tumor.
Patients with an implantable cardioverter-defibrillator or a pacemaker should not receive an MRI scan. Some CT scans might require a contrast medium to be ingested or injected before the scan. This contrast medium blocks X-rays and can help emphasize blood vessels or other structures that need to be examined.
If the patient is pregnant, Dr. Taqi may suggest postponing the procedure or choosing an examination that doesn’t involve radiation, such as an ultrasound or MRI.
Making the Incision and Inserting the Catheter
Dr. Taqi will make a small incision in the femoral artery, which is located in the groin at the top of one of the patient’s thighs. Assisted by imaging technology, Dr. Taqi will insert and feed the catheter through the incision, into the artery, and up to the tumor.
Once we confirm that a tumor has a prominent blood supply, then we can shut the blood flow down with an embolizing agent, which we will inject under X-ray guidance through the catheter. This embolizing agent could one of the following types:
Polymer agent. With similar properties to conventional superglues, these are pushed through the catheter towards the catheter tip into the blood vessels just short of the tumor itself. When the forward flow stops, they form a dense plug stopping the blood supply to the tumor.
Microspheres or microbeads. These are tiny polyvinyl alcohol spheres, suspended in a sterile solution, that are pushed through the catheter into the blood vessels just short of the tumor itself. As they flow, the blood vessels narrow, and the particles lodge within the vessel, forming a plug that stops the blood flow.
Microcoils. Made from platinum or platinum-like alloys, these are tiny coils that are pushed through the catheter with a special pusher rod. At the tip of the catheter, the coil deploys and forms a mesh within the vessel being treated. If required, more coils can then be deployed into this mesh. When enough mesh is present, blood flow stops.
All of these agents essentially perform the same task, and that is to reduce and stop the blood flow to the tumor. However, malignant tumors might require embolization with more potent agents, such as alcohol or chemotherapy drugs
Recovery from Tumor Embolization
Following the procedure, the patient will spend the night in intensive care, where we will closely monitor them. After returning home, the patient should be ready to return to work in one or two weeks.
A member of Dr. Taqi’s staff will keep in contact with the patient after being discharged from the hospital, and will discuss follow-up testing as needed.
If you or your loved one have been diagnosed with a tumor that requires embolization, then be sure to seek treatment from Southern California’s leading stroke prevention specialist and experienced neurointerventionalist, Dr. M. Asif Taqi. Contact him or call (805) 242-4884 to schedule your appointment today.