Coil embolization
- 27 yr old female
patient with secondary PPH
-Taken up for Uterine Artery Embolization.
- Pre-Procedure Angiogram done
Coil embolization
Bilateral uterine arteries were embolised using pushable coils. There was no further bleeding. Patient was stable.
Liquid - Polymers
- Onyx :
Liquid embolic agent, consisting of ethylene vinyl alcohol copolymer dissolved in dimethyl sulfoxide
(Onyx, Micro Therapeutics Inc., Irvine, CA).
- Onyx contains tantalum powder to render it
radiopaque. After Onyx is injected into the target lesion, the dimethyl sulfoxide solvent rapidly diffuses awa
y,
causing
precipitation of the polymer and formation of a spongy cast.
- The cast solidifies from the outside inj. Onyx allows a prolonged, controlled embolization because of its non
adhesive nature.
- Used mainly in Cerebral and Peripheral AVM embolization
Liquid - Polymers
Used for embolization of Cerebral AVMS, Peripheral AVMs.
Glue + lipidiol
- n butyl cyanoacrylate.
- This agent is a permanent rapidly acting liquid, similar to glues sold under trade names such as "SuperGlue, that
will polymerize immediately upon contact with ions. It also undergoes an exothermic
reaction which destroys the
vessel wall. Since the polymerization is so rapid, it requires a skilled surgeon. During the procedure, the surgeon
must flush the catheter before
and after injecting the NBCA, or the agent will polymerize within the catheter. The
catheter must also be withdrawn quickly or it will stick to the vessel. Oil can be mixed with NBCA to slow the rate
of polymerization.
- Ethiodol - Made from iodine and poppyseed oil, this is a highly viscous agent. It is usually used for
chemoembolizations, especially for hepatomas, since these tumors absorb iodine. The
half life is five days, so it
only temporarily embolizes vessels.
Sclerosing Agents
• Cause protein denaturation, leading to endothelial destruction and vascular occlusion. Occlusion by sclerosants is
usually permanent.
• Sodium tetradecyl sulphate (Setrol) and Polidocanol
• Uses : ablation of tumors, solid organs, veins, or vascular malformations.