The ultimate way to treat everything from obesity to sore knees? Block your blood vessels –

Clogged arteries cause millions of heart attacks and strokes worldwide each year.

However, doctors are now deliberately blocking blood vessels to treat a variety of conditions, such as arthritic knees and prostate issues.

The procedure – arterial embolization – involves completely cutting off blood flow to parts of the body by injecting materials that act like a dam.

Embolization was first developed in 1970 when an American doctor named Charles Dotter used a patient’s blood clot to plug an artery in the stomach to stop a life-threatening stomach bleeding.

Since then, the method has evolved to use materials such as tiny plastic beads or metal coils to create a permanent block to cut off blood flow.

The biggest advantage is that it can usually be done under local anesthesia and has relatively few side effects – it also allows access to areas of the body that surgeons sometimes can’t reach.

The technique is already used as a method to treat men with an enlarged prostate or benign prostatic hyperplasia (BPH).

As men age, the prostate, a walnut-shaped gland that surrounds the urethra (the tube that drains urine from the body), grows slowly to put pressure on the urethra in most cases, causing difficulty urinating.

Embolization of the arteries that supply blood to the prostate is an increasingly popular treatment option for shrinking prostate tissue.

A thin tube—a catheter—is inserted into an artery in the wrist or groin and is passed through the prostate, leaving thousands of microscopic spheres, each not much larger than one substance, to “punch” the artery.

The beads are made of some kind of plastic or gel that is not absorbed by the body, so they stay in place. Deprived of blood flow, the prostate gradually shrinks, releasing pressure on the urethra and allowing urine to flow more easily.

Embolization is being explored as an option for many other conditions as well…

40 minutes of obesity

Scientists at Imperial College London are testing a 40-minute obesity treatment that blocks blood flow to the upper stomach, where the hunger hormone ghrelin is released. Ghrelin is produced by cells lining the gastrointestinal tract: it is collected by the passage of blood and transported to the brain, which triggers the feeling of hunger.

The Imperial College London study, involving 76 patients, is based on the observation that appetite is reduced when blood flow to the lower stomach, upper stomach, is restricted.

For the trial, which begins in December 2021, half of the patients will have a catheter inserted through an artery in their wrist or groin to insert small plastic balls into an underlying artery, which will prevent interruption of the underlying blood flow. permanently.

The remaining patients will undergo the same procedure, but will not be injected with beads. Both groups followed for one year.

Scientists at Imperial College London are testing a 40-minute obesity treatment that blocks blood flow to the upper stomach, where the hunger hormone ghrelin is released.

Early studies in the United States showed that obese patients could lose more than 10% of their body weight within three months of the procedure.

The researchers hope that left gastric artery embolization – as it’s called – could be a cheaper and faster alternative to gastric bypass surgery with fewer side effects.

Dr. “It’s a promising and minimally invasive treatment, but there isn’t enough research yet to say how effective it may be,” says Prashant Patel, a clinical investigator at Imperial College London and one of the team who studied the procedure.

Treatment of painful fibroids

About 40% of women develop fibroids, blood-filled lumps that grow in or around the uterus and can cause heavy, painful periods. Fibroids usually develop during a woman’s reproductive years and do not shrink until after menopause.

They can cause fertility problems and miscarriage, and for some women the only treatment is a hysterectomy (surgical removal of the entire uterus).

In recent years however, arterial embolization has emerged as an alternative and is now available on the NHS (for women with large fibroids). Doctors cut off blood flow in one of the main arteries that carry oxygenated blood to the uterus and inject thousands of tiny particles or beads through a tube placed in the main artery in the groin.

Deprived of blood flow, fibroids will fade over the next few weeks and months.

A 2010 research review of the technique by the National Institute for Health and Care Excellence found that more than 80 percent of patients experienced improvement in symptoms six and 12 months after treatment.

However, embolization is generally reserved for women with large fibroids, and the NHS website warns that “While it is possible to have a successful pregnancy after the procedure, the overall effects on fertility and pregnancy are uncertain.”

Chemotherapy supplement for liver cancer

Doctors may use the arterial blocking technique in addition to chemotherapy to help eliminate liver tumors.

Treatment, trans-arterial chemoembolization (TACE), involves first injecting a chemotherapy drug directly into the liver tumor and then using microspheres to occlude the hepatic artery, a large blood vessel that supplies the liver (and any growing tumor). with blood I am working on it).

This allows the drug to start attacking the tumor while there is no blood supply to help it grow.

In some cases, doctors will block the artery with high-tech beads that slowly release the chemotherapy drug into the liver over several weeks.

In both approaches, the advantage is that higher doses of chemotherapy reach the tumor than it is simply injected into the bloodstream.

TACE treatment available on the NHS is generally reserved for patients who are not eligible for conventional surgery to remove the tumor, possibly due to age or general health.

It is sometimes used to shrink large tumors so they are easier to remove surgically.

Trials are also looking at its potential use in colon cancer and breast cancer.

Addressing piles and the risk of brain hemorrhages

Up to a third of the UK population will suffer from hemorrhoids or hemorrhoids – enlarged blood vessels in and around the anus that can result from constipation, heavy lifting or pregnancy.

Although creams can relieve pain, itching, and swelling, many people need hospital treatment to get rid of them, such as shrinking the growths with electricity or infrared light and zapping them to cut off blood flow. Severe cases may require surgery to remove them.

But a trial currently underway at John Radcliffe Hospital in Oxford is looking for an alternative: cut off blood flow by “packing” dozens of tiny stainless steel or platinum coils into an artery so that blood doesn’t get into swollen blood vessels. shrink them.

Soft, elastic, and tightly packed to form a barrier to blood, the coils are already used to treat brain aneurysms, where a dangerous bulge develops at a weak spot in an artery in the brain.

The coils get stuck in the bulge, preventing blood from entering, causing a potentially fatal rash or bleeding.

The batch trial, which treated 24 patients, is expected to be completed in 2023.

Dr. Raman Uberoi, a urologist who led the process, says: “If successful, it will pave the way for larger studies comparing it to the ‘gold standard’ of surgery.”

… It can also prevent knee pain

Reducing blood flow to the knee can help thousands of people who suffer from osteoarthritis, where wear destroys the joint cartilage that acts as a shock absorber.

Around 100,000 people in the UK need knee replacement surgery for osteoarthritis, but one in five report little improvement after surgery.

Since 2019, a trial has been underway at the Royal Berkshire Hospital in Reading to see if an hour-long procedure to block the geniculate artery, one of the main arteries supplying oxygenated blood to the knee, can reduce inflammation and pain in the knee. ‘articulation. .

When blood flows into the knee, it carries inflammatory cells that can worsen existing swelling and inflammation.

The new technique uses millions of tiny gelatin particles, each the size of a grain of sand, to seal off the artery.

A Japanese study found that treatment resulted in a 75% reduction in knee pain over a four-year period.

Interim results of the Royal Berkshire Hospital study, published last June in the journal Cardiovascular Interventional Radiology, showed that knee pain was reduced by nearly half in a group of 38 patients within three months of treatment.

However, NICE has since determined that there is insufficient evidence to support its widespread use on the NHS.