EMBOLOTHERAPY - AGENTS, CLINICAL-APPLICATIONS, AND TECHNIQUES

For embolization to be successful, three factors must be addressed: em bolic agent selection, clinical application, and technical skill. The major embolic agents used include stainless steel coils, absorbable ge latin pledgets and powder, polyvinyl alcohol foam, ethanol, and glues. Each of these agents acts at different levels in the arterial system; for example, coils are equivalent to surgical ligation and occlude me dium to small arteries, whereas liquid agents and the smaller diameter particles occlude at the arteriolar level or the capillary bed. The t ype of agent selected should also be determined according to clinical application, which includes trauma, tumors, male infertility, impotenc e, and vascular malformations. It may be better to occlude an artery o nly temporarily, particularly in trauma patients, and absorbable gelat in material is preferred for this application. Conversely, permanent o cclusion of arteries with either ethanol or polyvinyl alcohol foam par ticles may be necessary in the treatment of tumors. To use embolothera py effectively, the interventional radiologist must be experienced, fa miliar with the underlying pathologic processes, and knowledgeable wit h regard to the role of other specialties in the treatment of the dise ase process presented.