Embolization therapy is a non-surgical procedure to treat inoperable metastatic liver tumors . Small particles or beads, ranging in size from 100 to 900 microns made of a biocompatible resin , are injected into selected vessels to block the blood flow feeding the tumors causing the tumor to shrink.
Embolization therapy is performed by an interventional radiologist in the radiology suite.
Under local anaesthesia , a small incision is made in the groin to access the femoral artery and a narrow guidewire is inserted. Under guidance of an x-ray machine, a delivery catheter is inserted over the wire (angiography ). The tip of the catheter is positioned so that the particles will be delivered to the tumor. Particles are injected until the embolization is complete and the artery is blocked.
Over the following months, the embolized vessels will permanently shrink and the tumor will decrease in size.
Embolization can be performed with bland particles (without drug added), or with drug added. If a drug is added, the embolization is referred to as TACE (Transarterial Chemoembolization).
Cutting off the blood supply to the tumor allows for higher doses of chemotherapy to be delivered and remain in contact with the tumor. It helps prevent the chemotherapy reaching healthy tissue.
TACE normally contains a mixture of bland particles and two to three chemotherapy agents. TACE may also be performed using different particles made of a biocompatible resin modified for the controlled loading and delivery of drug. These particles are called drug eluting beads (DC Bead or DEBIRI) . Drug eluding beads are mixed with one chemotherapy agent (Irinotecan )4 and contrast dye. The beads will absorb the chemotherapy agent and once injected into the tumor will slowly release the drug over days.
Side Effects: The side effects will differ depending upon the type of embolization used. The most common complications reported are as follows:
- Hepatic injury
- Liver abscess
- Pain nausea
- Severe post embolization syndrome (fever, pain, extreme fatigue, nausea/vomiting)
Recovery: Most patients can be discharged a few hours after the procedure. If post embolization syndrome occurs an overnight stay is normally required.