Treatment of Brain Tumors with Catheterization

The brain is a unique organ that enables perception and is responsible for complex reactions. Diagnosis of brain cancer can be a very frightening and exhausting experience, as brain cancer treatment is a delicate process that requires the highest level of skills, and this is what Al Hayat Center for Interventional Radiology and Neurointervention is keen to provide for brain tumor patients in Iraq. There is more hope than ever for those suffering from brain tumors, as research has led to the emergence of advanced treatments such as catheterization of brain tumors through interventional radiology.

Some brain tumors can bleed heavily during surgery, making open surgery extremely difficult and sometimes impossible. Blocking the blood vessels that feed these tumors, before starting the surgery, through brain catheterization alleviates this difficulty.

The goal of brain tumor treatment is to destroy the cancer cells without harming other parts of the body. The Interventional Radiology Department uses imaging techniques to directly guide to the cancer site, focusing on its blood supply. One of the most important imaging techniques at Al Hayat Center for Interventional Radiology and Neurointervention is the latest global Incisive CT scanner, the first device in Iraq specialized for radiological interventions using artificial intelligence.

The technique of treating tumors with interventional radiology is for the first time in Iraq at the Warith International Institute, where it aims to stop the blood supply that feeds the tumors through minimal intervention by placing a catheter in the patient's thigh and carefully guiding it to the blood vessels that feed the tumor under X-ray guidance. The blood vessels are imaged to check the tumor's blood supply and verify that it is safe to cut off this blood vessel. The substance is injected through the catheter to block the blood vessels under X-ray guidance. Sometimes, malignant tumors require an injection of stronger agents, such as chemotherapy drugs.

Brain tumors contain many blood vessels and can lead to severe blood loss during open surgery to remove them.

Cerebral catheterization aims to block as many blood vessels as possible to minimize blood loss during surgery, making it safer, easier, and sometimes faster. The blood supply to the tumor is also cut off. Cerebral catheterization is an adjunct to treating brain tumors before open surgery.

The cerebral catheterization procedure involves making a small incision and directly injecting medical glue, small coils, or sand-like particles into the blood vessels feeding the tumor, using the interventional radiology and brain catheterization facilities at Al Hayat Center. This unit includes the latest catheterization system (Azurion 7B 20 Clarity) which images arteries and veins without using contrast dye, so it is useful for patients with kidney problems.

The entire procedure is done through a small plastic tube (catheter) placed into the blood vessels feeding the tumor, using X-rays to guide the catheter insertion and ensure it is in the right position before injecting the glue, particles, or coils into the blood vessels.

• A medical examination is performed to ensure you are fit for the procedure and anesthesia, conduct any necessary blood tests, and provide you with any special information or medication you may need before the procedure.

• This procedure is performed under general anesthesia or local anesthesia that will numb the skin to make a small incision for inserting the catheter; therefore, fasting is required overnight or for at least 4 to 6 hours.

• If you are taking medication, the doctor will discuss with you whether you should continue taking your medication and will give you complete instructions. If you have diabetes, kidney disease, thyroid disease, or are taking blood-thinning medications (anticoagulants), special instructions will be provided.

• If general anesthesia is required, the anesthesiologist will examine you again on the day of the procedure to ensure you are fit for anesthesia.

• A cannula will be inserted into a vein in your arm to administer any necessary medication.

• The nurse will shave your groin area to provide clear access to the artery located in it

• After injecting a local anesthetic into the thigh to numb the area, a small incision (less than one centimeter) is made in the skin of the thigh. Through this small incision, a small needle punctures the artery in the thigh to insert a catheter (a long, thin, hollow tube) into the artery that feeds the tumor.

• Through this catheter, initial imaging is performed to identify the blood vessels and help determine the best and safest way to block the blood vessels feeding the tumor.

• Then, various blocking agents are injected through the catheter into the blood vessels feeding the tumor. These may be a special medical glue, small coiled wires, or sand-like particles that can reduce or completely stop the blood flow in the vessels feeding the tumor.

• At the end of the procedure, an internal stitch or suture may be used to close the puncture in the thigh artery.

• The goal of the procedure is to block as many blood vessels as possible to reduce or stop the blood flow to the tumor.

• The aftereffects of brain catheter angiography are generally mild and related to general anesthesia, where the patient may experience temporary nausea or vomiting, but this can be controlled with prescribed medications.

• A minor bruise may form in the thigh, but this usually heals within days to a few weeks.

The time required depends on the tumor. Therefore the time is highly variable and unpredictable. It usually takes between 2 to 6 hours. The hospital stay is typically 1 to 2 days at most.

Blocking the blood supply to brain tumors will reduce blood loss during open surgery, making it safer.

An interventional radiologist performs the brain catheterization. He is a medical specialist trained to carry out this procedure.

We can relieve the pain of many patients through interventional radiology without the need to travel outside of Iraq, by applying various interventional radiology applications with the latest global equipment at Al Hayat Center for Interventional Radiology and Neurointervention in Karbala, under the supervision of many distinguished medical team who have extensive experience in interventional radiology and hold the highest academic degrees in this field.