What is Preoperative Tumour Embolisation?
Preoperative tumour embolisation is an interventional radiology procedure performed before a planned surgical tumour resection. Using X-ray guidance (fluoroscopy), a thin catheter is guided through the blood vessels to the arteries supplying the tumour. Tiny particles, coils, or other embolic agents are then injected to block (embolise) these feeding vessels, starving the tumour of its blood supply.
By cutting off the tumour's vascularity before surgery, the surgeon can operate in a far less bloody field. This translates to shorter operating times, reduced need for blood transfusions, and a lower risk of surgical complications especially important for highly vascular tumours such as renal cell carcinoma metastases, meningiomas, paragangliomas, and hepatocellular carcinomas.
Who Needs This Procedure?
This procedure is recommended for patients with highly vascular tumours that carry a significant risk of blood loss during open or laparoscopic surgery. Common indications include large renal cell carcinoma (kidney cancer) prior to nephrectomy, hypervascular bone metastases such as those from thyroid or renal cancer before skeletal surgery, meningiomas and other vascular brain tumours before neurosurgical intervention, and paragangliomas or glomus tumours in the head and neck region. It is also indicated in hepatocellular carcinoma (HCC) prior to partial liver resection, as well as in selected cases of uterine fibroids before myomectomy when surgery is still planned.
How is the Procedure Performed?
- Preparation: You may be asked to fast for 4–6 hours. Blood tests and imaging (CT/MRI angiography) are reviewed beforehand to map tumour vessels.
- Access: Under local anaesthesia and sedation, a small nick is made at the groin (femoral artery) or wrist (radial artery). A thin, flexible catheter is inserted into the artery.
- Navigation: Using real-time X-ray (fluoroscopy) and contrast dye, Dr. Shetty precisely navigates the catheter to the arteries feeding the tumour.
- Embolisation: Tiny microspheres, platinum coils, or liquid embolic agents are injected to permanently block the tumour's blood supply. A final angiogram confirms successful embolisation.
- Completion: The catheter is removed and a small closure device or manual pressure is applied. You are typically observed overnight before surgery proceeds the next day.