Endovascular Embolization

(Endovascular Coiling)

Pronounced: endo-vas-kyoo-lar embo-lie-zay-shun

Definition

Definition

This is a procedure to fill and/or close blood vessels. This prevents bleeding and rupture. It is an alternative to open surgery.

Reasons for Procedure

Reasons for Procedure

Endovascular embolization can treat many conditions, including:

  • Brain aneurysm —a weakened blood vessel in the brain that collects blood and can bleed
  • Vascular malformations —abnormal connections between arteries and veins (usually present at birth)
  • Tumors

Brain Aneurysm

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The procedure can be used alone or with other treatments. It will not fix damaged areas of the brain, but it can improve quality of life by stopping bleeding or preventing rupture.

Possible Complications

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Bleeding
  • Weakness
  • Numbness or tingling
  • Speech disturbances
  • Visual changes
  • Confusion, memory loss
  • Seizures
  • Infection
  • Reaction to the anesthesia or contrast solution
  • Blood clots
  • Ruptured aneurysm during surgery

Factors that may increase the risk of complications include:

What to Expect

What to Expect

Prior to Procedure

Your appointment before the surgery may include:

  • Physical exam, blood and imaging tests
  • Discussion of allergies, your medications, recent illness or conditions, risks and benefits of the procedure
  • Pictures of the blood vessels to be treated may be taken with

  • Arrange for a ride home.
  • The night before the procedure, do not eat or drink anything after midnight.
  • Discuss your medications with your doctor. You may be asked to stop taking certain medications.

Women should let their doctor know if they are pregnant or planning to become pregnant.

Anesthesia

General anesthesia will be used. It will block any pain and keep you asleep through the surgery.

Description of the Procedure

The doctor will monitor your blood pressure, heart rate, and pulse. An IV will be placed in your arm for sedation and anesthesia. The nurse will shave and sterilize the groin area. The catheter will be inserted in this area.

The doctor will make a tiny incision in your groin area to access an artery. The catheter will be placed in the artery and threaded up to the site. A special dye will be given through the catheter. The doctor will be able to see the catheter pathway on a monitor. X-rays will help the doctor find the exact weakened or malformed area.

Once the catheter is in position, medication, coils, or man-made material will be inserted into the catheter to the site. This will close or fill the blood vessel. Imaging tests will be done to make sure the blood vessels have closed.

Immediately After Procedure

The catheter and IV line will be removed. You will lie still for 6-8 hours.

How Long Will It Take?

30 minutes or longer—more complex procedures may take several hours.

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay

This procedure is done in a hospital setting. The usual length of stay is 2 days. If you have any complications, you will need to stay longer.

Post-procedure Care

At the Hospital

  • You will rest for several hours in bed.
  • Your vital signs will be monitored.

During your stay, the hospital staff will take steps to reduce your chance of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered.

There are also steps you can take to reduce your chance of infection, such as:

  • Washing your hands often and reminding your healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incision

At Home

When you get home, you may have to adjust your activity level while you recover. This may take up to a week. Home care may include:

  • Resting when you need to
  • Caring for the wound
  • Physical or rehabilitative therapy

Call Your Doctor

Call Your Doctor

It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:

  • Any changes in physical ability, such as balance, strength, or movement
  • Any changes to mental status, such as consciousness, memory, or thinking
  • Weakness, numbness, tingling
  • Signs of infection including fever and chills
  • Redness, swelling, increasing pain, bleeding, or discharge from the incision site
  • Headache
  • Changes in vision
  • Fainting
  • Pain that cannot be controlled with the medications you’ve been given
  • Persistent nausea or vomiting
  • Trouble controlling your bladder and/or bowels
  • Pain, swelling, or cramping in your legs

Call for emergency medical services right away if any of the following occurs: 

  • Seizure
  • Shortness of breath or chest pain
  • Loss of consciousness

If you think you have an emergency, call for medical help right away.

RESOURCES:

The Brain Aneurysm Foundation http://www.bafound.org

National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov

CANADIAN RESOURCES:

Brain Injury Association of Canada http://biac-aclc.ca

Heart and Stroke Foundation Canada http://www.heartandstroke.ca

References:

Catheter embolization. Radiological Society of North America Radiology Info website. Available at:
http://www.radiologyinfo.org/en/info.cfm?pg=cathembol
Updated August 14, 2013. Accessed May 29, 2014.

Endovascular (embolization) treatment of aneurysms. The Toronto Brain Vascular Malformation Study Group website. Available at:
http://brainavm.oci.utoronto.ca/malformations/embo_treat_aneurysm_index.htm
Accessed May 29, 2014.

Subarachnoid hemorrhage. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated May 2, 2014. Accessed May 29, 2014.

Last reviewed June 2015 by Michael Woods, MD
Last Updated: 5/29/2014

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