Article - Embolization of Chest Vascular

Embolization of Chest Vascular Malformations

Embolization of vascular malformations in the chest is an advanced medical procedure performed within the field of interventional radiology designed to treat abnormal connections between blood vessels in the lungs or chest wall. The most common condition treated with this method is pulmonary arteriovenous malformation, a condition where a direct connection exists between an artery and a vein without passing through the normal capillary network. This condition can cause a decrease in blood oxygen levels because the blood does not undergo proper filtration and oxygenation in the lungs, and in some cases, it can lead to significant complications such as stroke or brain infections due to the passage of blood clots or bacteria directly into the systemic circulation.

The procedure begins with a small puncture, usually in the groin area, through which a thin catheter is inserted into the vascular system. Under real time x-ray guidance, the interventional radiologist navigates the catheter through the heart into the pulmonary arteries until precisely reaching the faulty blood vessel. Once the catheter is positioned correctly, specialized blocking materials such as small metallic coils or special plugs made of nitinol are inserted through it. These materials stop the blood flow to the malformation and force the blood to flow only through normal blood vessels. The procedure is usually performed under deep sedation or local anesthesia, allowing the patient to undergo the process without significant pain while maintaining communication with the medical staff if necessary.

The treatment is suitable for patients suffering from shortness of breath, low oxygen levels, or those diagnosed with vascular malformations on a chest x-ray or CT scan. Thanks to the high precision of modern equipment, it is possible to treat even very small malformations located deep in the lung, which was very difficult to perform in the past using conventional surgery. After the procedure is completed, the catheter is removed from the body and local pressure is applied to the puncture site to prevent bleeding.

Among the advantages are

Performed through a tiny skin puncture without the need for large surgical incisions or opening the chest cavity.
Recovery time and return to daily routine are significantly faster compared to open surgical lung procedures.
Focused blockage of the problematic blood vessels while maximally preserving the surrounding healthy tissue.
Dramatically reduces future risk of stroke or other neurological complications associated with the malformation.
Most patients are discharged to their homes within only one day of the procedure.
Multiple different malformations can be treated in the same session without the need for repeated interventions.

Disadvantages and risks

Rare possibility of the blocking materials moving from the intended location to other blood vessels in the body.
Local infection or bruising may occur at the catheter insertion site in the groin requiring medical follow up.
An allergic reaction may develop to the contrast material injected during imaging for catheter navigation.
There is a very low risk of damage to the blood vessel wall during the navigation of the catheter to the lungs.
Sometimes supplementary treatment is required if the malformation is particularly large or if new bypass blood vessels form over time.