Pioneered at UPMC, a new technique using microcoil embolization shows early promise in treating inoperable placental tumors

Sometimes a non-cancerous tumor can still be deadly — especially when it’s a chorangioma, a tumor that grows on the fetal side of the placenta and threatens the health of both the fetus and the mother. UPMC’s innovative application of a proven technique for shrinking tumors now offers hope for treating this rare, but serious, condition.

The new technique uses microcoil embolization to block the supply of blood to the chorangioma by strategically placing a tiny metal coil in the feeding artery to create a clot.

Proven to Shrink Tumors Elsewhere

Embolization is a minimally-invasive procedure used to stabilize aneurisms and stop hemorrhages in veins and arteries by inducing a blood clot to block flow. It is widely used to shrink tumors in the brain, liver, and other parts of the body. Stephen Emery, MD, director of the Center for Innovative Fetal Intervention at UPMC Magee-Womens Hospital, was inspired to apply the technique in a new way when he was presented with an inoperable chorangioma that was endangering the health of a mother and her unborn son. “I thought, what would you do to a tumor in any other body compartment that’s basically inoperable? You would embolize it. That’s standard treatment.”

Though embolization had never been performed on a giant chorangioma, Dr. Emery reasoned that it could be used to shut off blood flow to the tumor and starve it. Since the coil would be inserted into the blood vessel through a thin catheter, the technique would be minimally invasive with respect to the placenta and uterus.

UPMC’s Center for Innovative Fetal Intervention had the resources to support the procedure. “I talked with our interventional radiologist, and he agreed,” says Dr. Emery. “He has years of experience embolizing tumors and I have years of experience accessing fetal blood vessels. Together, we had the experience needed to perform the operation.”

Restoring Blood and Oxygen to the Fetus

When Dr. Emery and the UPMC team performed the procedure, the microcoil embolization stopped the blood flow instantly, killing the tumor while leaving the placenta intact, and restoring normal blood and oxygen flow to the fetus. The fetus recovered, the pregnancy continued, and the mother delivered a healthy baby boy.

“People have tried all sorts of ways of doing this using fetoscopes and bipolar cautery, with really mixed results,” says Dr. Emery. “This is the first time where it was a very, very minimally invasive procedure, extremely safe for mom, with a successful outcome.”

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Lower Risk, Better Odds

With these promising results, Dr. Emery sees value to the continued use of the technique. Although they are rare, life-threatening chorangiomas can occur in patients who live far from advanced fetal care centers like UPMC. “One of the benefits of this technique is that you can do it just about anywhere — you don’t need elaborate facilities,” explains Dr. Emery. “There’s minimal anesthesia and minimal trauma involved. Because it’s so low risk, you can perform it earlier in the pregnancy, when the odds of a positive outcome are better.”

The Center for Innovative Fetal Intervention at UPMC

Pioneering ways to save new lives is central to the mission of UPMC’s Center for Innovative Fetal Intervention. Founded by Dr. Emery in 2007, the center brings together the powerful resources of UPMC Magee-Womens Hospital, the University of Pittsburgh McGowan Institute for Regenerative Medicine, UPMC Children’s Hospital of Pittsburgh, and Magee-Womens Research Institute to pioneer new, cutting-edge techniques to share with the global medical community. As a member of the North American Fetal Therapy Network, a consortium of 35 academic centers in the United States and Canada that will share the research, the UPMC Center for Innovative Fetal Intervention is at the forefront of advancing the science of saving very tiny, very fragile lives worldwide.