Endovascular embolization

 

Alternative Names

Treatment - endovascular embolism; Coil embolization; Cerebral aneurysm - endovascular; Coiling - endovascular; Saccular aneurysm - endovascular; Berry aneurysm - endovascular repair; Fusiform aneurysm repair - endovascular; Aneurysm repair - endovascular

Definition

Endovascular embolization is a medical procedure to treat abnormal blood vessels in the brain and other parts of the body. It is an alternative to open surgery.

This procedure cuts off the blood supply to a certain part of the body.

Why the Procedure Is Performed

The procedure is most often used to treat aneurysms in the brain. But it may be used for other medical conditions when open surgery is considered risky. The goal of the treatment is to prevent bleeding in the problem area and to reduce the risk that the blood vessel will break open (rupture).

Not all aneurysms need to be treated right away. Those that are very small (less than 3 mm) are less likely to break open.

Your doctor will help you decide whether it is safer to have surgery to block off the aneurysm before it can rupture.

This procedure may be used to treat:

  • Arteriovenous malformation (AVM)
  • Brain aneurysm
  • Carotid artery cavernous fistula (a problem with the large artery in the neck)
  • Certain tumors

Risks

  • Bleeding at the site of the needle puncture
  • Bleeding in the brain
  • Damage to the artery where the needle is inserted
  • Dislodged coil or balloon
  • Failure to completely treat the abnormal blood vessel
  • Infection
  • Stroke
  • Symptoms that keep returning

Before the Procedure

This procedure is often performed on an emergency basis. If it is not an emergency:

  • Tell your doctor or nurse what drugs or herbs you are taking and if you have been drinking a lot of alcohol.
  • Ask your doctor which medicines you should still take on the day of the surgery.
  • Try to stop smoking.
  • You will usually be asked not to eat or drink anything for 8 hours before the surgery.
  • Take the medicines your doctor told you to take with a small sip of water.
  • Arrive at the hospital on time.

After the Procedure

If there was no bleeding before the procedure, you may need to stay in the hospital for 1 - 2 days.

If bleeding occurred, your hospital stay will be longer.

Outlook (Prognosis)

How fast you recover depends on your overall health, the severity of your medical condition, and other factors.

In most cases, endovascular embolization is a successful procedure with good outcomes.

The outlook also depends on any brain damage that occurred from bleeding before, during, or after the surgery.

References

Brinjikji W, Lanzino G, Cloft HJ, Rabinstein A, Kallmes DF. Endovascular treatment of very small (3 mm or smaller) intracranial aneurysms: report of a consecutive series and a meta-analysis. Stroke. 2010;41:116-121.

Mack W, Dusick JR, Martin N, Gonzalez N. Principles of endovascular therapy. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012: chap 47.

Meyers PM, Schumacher HC, Higashida RT, Barnwell SL, Craeger MA, Gupta R, et al. American Heart Association Indications for the performance of intracranial endovascular neurointerventional procedures: a scientific statement from the American Heart Association Council on Cardiovascular Radiology and Intervention, Stroke Council, Council on Cardiovascular Surgery and Anesthesia, Interdisciplinary Council on Peripheral Vascular Disease, and Interdisciplinary Council on Quality of Care and Outcomes Research. Circulation. 2009;119:2235-2249.

Review Date: 2/6/2013
Reviewed By: Matthew M. Cooper, MD, FACS, Medical Director, Cardiovascular Surgery, HealthEast Care System, St. Paul, MN. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

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