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Preoperative Tumour Embolisation

A minimally invasive, image-guided procedure to block a tumour's blood supply before surgery reducing intraoperative blood loss and improving surgical outcomes.

Minimally Invasive Procedure

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.
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Benefits of Preoperative Tumour Embolisation

Dramatically Reduced Blood Loss

Blocking the tumour's blood supply significantly cuts intraoperative haemorrhage and the need for transfusions.

Safer Surgery

A less vascular tumour is easier to resect, reducing operative time and overall surgical risk.

Better Surgical Margins

Clearer operating field allows the surgeon to achieve more complete and precise tumour removal.

Minimally Invasive

Performed through a tiny skin puncture no major incision required for the embolisation itself.

Frequently Asked Questions

Embolisation is typically performed 24–72 hours before the planned surgery. This timing allows the tumour's vascularity to reduce maximally while the collateral circulation hasn't yet re-established. Dr. Shetty coordinates the timing closely with your surgical team.
The procedure itself is performed under sedation and local anaesthesia, so you will feel little to no pain during it. Afterwards, post-embolisation syndrome can cause moderate pain and discomfort at the tumour site, which is managed effectively with prescribed medications for 24–48 hours.
Highly vascular tumours benefit most including renal cell carcinoma, meningiomas, paragangliomas, hepatocellular carcinoma, and hypervascular bone metastases from thyroid or renal cancers. Dr. Shetty reviews your imaging to determine if embolisation would benefit your specific case.
Like all procedures, there are small risks including post-embolisation syndrome, access-site bruising, contrast allergy, and rarely, non-target embolisation. However, when performed by an experienced interventional radiologist, these risks are minimal and are far outweighed by the surgical benefits.
In the preoperative context, embolisation is a preparatory step not a substitute for surgery. It is specifically designed to make the surgical resection safer and more effective. For some patients who are not surgical candidates, embolisation may be used as a palliative or definitive treatment, but this is a separate clinical decision.
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Planning a tumour resection? Let's prepare safely.

Consult with Dr. Gurucharan S Shetty to evaluate whether preoperative embolisation can reduce risk and improve your surgical outcome.

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