Endovascular Embolisation

What is endovascular embolisation?

Endovascular embolisation is a minimally invasive procedure used to block abnormal blood vessels or blood flow within the body.

This technique involves the insertion of a catheter through the blood vessels, typically starting from the groin or wrist, and guiding it to the site of the abnormality using advanced imaging technology. Once in place, embolic agents such as coils, particles, or liquid adhesives are delivered through the catheter to obstruct the targeted vessels.

This procedure is commonly used to treat conditions like aneurysms, arteriovenous malformations (AVMs), and certain types of tumours.

Why do you need endovascular embolisation?

Endovascular embolisation is recommended for various medical conditions that involve abnormal or excessive blood flow. Some of the primary reasons for needing this procedure include:

• Aneurysms. To prevent rupture and bleeding by blocking the aneurysm.
• Arteriovenous Malformations (AVMs). To reduce the risk of bleeding by closing off abnormal blood vessels.
• Tumours. To decrease blood supply to tumours, reducing their size or preparing them for surgical removal.
• Chronic nosebleeds. To stop persistent and severe nosebleeds by embolising the blood vessels in the nasal area.
• Pelvic congestion syndrome. To alleviate pain caused by varicose veins in the pelvis.

What are the risks and complications of endovascular embolisation?

While endovascular embolisation is generally safe, it carries some risks and potential complications:

• Bleeding or haematoma. At the catheter insertion site.
• Infection. At the site of insertion or within the treated area.
• Allergic reactions. To the contrast dye used during the procedure.
• Vessel damage. Potential damage to the blood vessels during catheter insertion.
• Stroke. If embolic material migrates to the brain.
• Non-target embolisation. Unintended blockage of healthy blood vessels.

How do you prepare for endovascular embolisation?

Preparation for endovascular embolisation involves several steps:

• Medical evaluation. Your doctor will review your medical history, conduct a physical examination, and order necessary imaging tests.
• Medications. You may need to stop taking certain medications, especially blood thinners, before the procedure.
• Fasting. You may be required to fast for a specific period before the procedure.
• Consent. You will be asked to sign a consent form, acknowledging the procedure and its potential risks.

What can you expect during endovascular embolisation?

Estimated Duration of the Procedure

The procedure typically takes between 1 to 3 hours, depending on the complexity and location of the abnormality.

Before the procedure

• You will be given a hospital gown and asked to remove any jewellery or personal items.
• An intravenous (IV) line will be placed in your arm to administer fluids and medications.
• You will be taken to the procedure room and positioned on the operating table.
• Local anaesthesia will be administered at the catheter insertion site, and you may receive sedation to help you relax.

During the procedure

• The insertion site (usually the groin or wrist) will be cleaned and sterilised.
• A small incision will be made to insert the catheter into a blood vessel.
• Using fluoroscopy (real-time X-ray imaging), the catheter will be guided to the target area.
• Embolic agents will be delivered through the catheter to block the abnormal blood vessels.
• Once the embolisation is complete, the catheter will be removed, and the insertion site will be closed.

After the procedure

• You will be taken to a recovery area for monitoring as the anaesthesia and sedation wear off.
• You may experience some discomfort at the insertion site, which can be managed with pain medication.
• Temporary side effects may include mild bruising, swelling, or fatigue.

Care and recovery after an endovascular embolisation

Expected period for recovery

Recovery time varies depending on the individual and the complexity of the procedure, but most patients can expect to resume normal activities within a few days to a week.

Recovery tips

• Attend all scheduled follow-up appointments to monitor your recovery.
• Take prescribed medications as directed to manage pain and prevent infection.
• Allow yourself plenty of time to rest and avoid strenuous activities.
• Maintain a healthy diet and stay hydrated to support healing.
• Keep the insertion site clean and dry to prevent infection.

What your recovery progression will depend on

• Severity of the original condition
• Your general health and pre-existing conditions
• Adherence to care instructions
• How well your body responds to the procedure and subsequent treatments.