Endovascular embolization (EE) is a surgical procedure. It is used to treat abnormal blood vessels found in the brain or other areas of the body. This procedure is an alternative to open surgery. It blocks vessels to cut off blood flow to an area.
Your doctor may recommend EE if you suffer from one of the following conditions:
- brain aneurysms—bulging weak spots in the walls of blood vessels in the brain
- tumors such as uterine fibroids—can be shrunk by blocking their blood flow
- abnormal growths in your circulatory system
- excessive nosebleeds
- arteriovenous malformations (AVMs) of the brain and spine—knots of blood vessels which are susceptible to bleeding
EE can be used as the sole form of treatment or as a prelude to another surgery. Blocking off the blood flow to a damaged area can make surgery safer.
This type of procedure is often performed in an emergency, in which case there is no time for preparation. If it is not performed as an emergency treatment, you should:
- inform your doctor of any prescription, over-the-counter, or herbal medications you are taking
- let your doctor know if you drink alcohol on a regular basis
- stop or reduce smoking
- avoid food and drink eight hours prior to the procedure
- arrange for someone to drive you home after your procedure
EE is performed in a hospital. During the procedure, your surgeon will make a tiny incision in your groin. A catheter is then inserted through a large blood vessel in your leg called the femoral artery. The catheter is guided through your body’s circulatory system using X-ray.
When the catheter reaches the location of the abnormality to be treated, material is injected to seal the blood vessel. A number of different agents may be used, including:
- biologically inert glues that do not interact with your tissues
- tiny plastic particles that lodge tightly in the vessel
- metal coils
- surgical balloons
The type of agent your surgeon uses will depend on the problem that is being treated.
There are a number of risks linked to this procedure. These include:
- bleeding into the brain
- bleeding at the site of the incision
- damage to the artery where the catheter is inserted
- failure of the blocking agent
- recurring symptoms
This procedure is sometimes performed under general anesthesia. Anesthesia may have risks beyond those inherent in the procedure. Some potential, but rare, complications include:
- heart attack
- lung infection
- temporary mental confusion
You will usually need to remain in the hospital for one or two days. You may be kept longer if bleeding occurs before, during, or after the EE.
Your rate of recovery will depend on your general state of health at the time of the procedure. Your underlying medical condition will also affect your recovery speed.
Outlook depends on the condition being treated. Brain damage caused by bleeding before, during, or after the procedure may not be reversible. Although the goal is to prevent damage, sometimes AVMs and other malformations are not discovered until they have already begun to bleed.
Most often, EE is successful and has a good outcome. It can reduce the risk of bleeding from a burst aneurysm or other venous malformations. It can also decrease pain from tumors and make nosebleeds less frequent.