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The treatment of hypervascular tumours presents a significant challenge to healthcare professionals due to the extensive network of blood vessels supplying these tumours. The presence of a high vascular density can complicate surgical resection, increasing the risk of excessive bleeding, prolonged operative times and potential clinical complications. Embolisation is frequently employed as part of a comprehensive treatment strategy in these cases. This technique involves deliberately blocking the tumour’s blood supply, thereby reducing intraoperative blood loss and improving the feasibility of surgical excision.

The Challenges and Potential Risks

The mitigation of risks when treating hypervascular structures around a tumour in any part of the body requires extensive planning and preparation. It can be difficult to distinguish between tumour and vessels, and to establish a safe resection pathway. This is why a comprehensive assessment with diagnostic imaging such as CT or MRI solutions are crucial as part of the planning process.ⁱ Histological evaluation further aids in understanding the tumour’s behaviour and vascularisation, informing a strategic and individualised surgical plan.

Although embolisation is a well-established technique, like any medical procedure, it is not without risks. The potential complications include respiratory issues, for which risk factors include reoperation and a higher score on the surgical invasiveness index.ⁱⁱ Other risk factors for complications are older age (over 65) and thoracic surgery. However, when performed with precision and careful patient selection, these risks can be minimised, ensuring the safety and effectiveness of treatment.

Benefits of Embolisation

Despite continued discussion in the field, evidence demonstrates that meticulous embolisation of carotid body tumours and immediate resection is associated with reduced blood loss and surgical time.ⁱⁱⁱ Researchers have also found low complication rates associated with the embolisation procedure of just 3%, with success reported in the treatment of spinal tumours.^iv

As the vertebral column is the most common site of bony metastasis, research continues into the optimisation of treatment techniques in the area. A systematic review confirmed that preoperative arterial embolisation of hypervascular tumours could prove beneficial in the reduction of bleeding and operative times.^v

Choosing the Right Equipment 

For the best outcomes, it is important that the clinician selects equipment carefully for the procedure at hand. For example, the Varian Embozene Microspheres from Getz healthcare are indicated for the embolisation of hypervascular tumours, as well as arteriovenous malformations, uterine fibroids and several other clinical situations. They are highly calibrated and are designed to be compressible and robust for smooth catheter delivery, as well as highly biocompatible and uniquely colour-coded by size for professional efficiency, safety and convenience.

Their advanced features and clinical versatility position them as a reliable choice for achieving effective and controlled embolisation across a range of treatment approaches.

Find out more about the Varian Embozene Microspheres from Getz Healthcare here.

ⁱ Nakamura H, Tanaka S, Miyanishi K, et al. A case of hypervascular tumors in the liver and pancreas: synchronous hepatocellular carcinoma and pancreatic metastasis from renal cell carcinoma 36 years after nephrectomy. Clin Case Rep. 2021; 9: 932–937. https://doi.org/10.1002/ccr3.3691
ⁱⁱ Tang B, Ji T, Tang X, Jin L, Dong S, Guo W. Risk factors for major complications in surgery for hypervascular spinal tumors: an analysis of 120 cases with adjuvant preoperative embolization. Eur Spine J. 2015 Oct;24(10):2201-8. doi: 10.1007/s00586-015-4122-8. Epub 2015 Jul 18. PMID: 26187620.
ⁱⁱⁱ Shiga K, Katagiri K, Ikeda A, Saito D, Oikawa SI, Tsuchida K, Miyaguchi J, Kusaka T, Tamura A. Challenges of Surgical Resection of Carotid Body Tumors - Multiple Feeding Arteries and Preoperative Embolization. Anticancer Res. 2022 Feb;42(2):645-652. doi: 10.21873/anticanres.15522. PMID: 35093862.
^iv Binh NT, Hoa TQ, Linh LT, My TT, Anh PQ, Duc NM. Preoperative embolization of hypervascular spinal tumors: Two case reports. J Clin Imaging Sci. 2022 May 2;12:21. doi: 10.25259/JCIS_20_2022. PMID: 35673594; PMCID: PMC9168289.
^v Al-Mistarehi AH, Slika H, El Baba B, Sattari SA, Weber-Levine C, Jiang K, Lee SH, Redmond KJ, Theodore N, Lubelski D. Optimizing surgical strategies: a systematic review of the effectiveness of preoperative arterial embolization for hyper vascular metastatic spinal tumors. Spine J. 2025 Jan 13:S1529-9430(25)00017-8. doi: 10.1016/j.spinee.2024.12.032. Epub ahead of print. PMID: 39814208.