Endovascular embolization (EE) is an invasive surgical procedure. It’s used to treat abnormal blood vessels found in your brain, as well as other areas of your body. This procedure is an alternative to open surgery. It blocks blood vessels to cut off blood flow to an affected area.
Your doctor may recommend EE if you experience one of the following conditions:
- brain aneurysms, which are bulging weak spots in the walls of blood vessels in your brain
- tumors such as uterine fibroids, which can be shrunk by blocking their blood flow
- abnormal growths in your circulatory system
- arteriovenous malformations (AVMs) of your brain and spine, which are knots of blood vessels that are susceptible to bleeding
- excessive nosebleeds
EE can be used as the sole form of treatment, or it can be done before another surgery. Blocking off the blood flow to a damaged area can make surgery safer.
EE is often performed in an emergency, in which case you have no time for preparation. If it’s not performed as an emergency treatment, you should:
- inform your doctor of any prescription, over-the-counter, and herbal medications you’re taking, including aspirin or other blood-thinning products
- let your doctor know if you drink alcohol regularly
- stop or reduce smoking if you smoke
- avoid eating and drinking for eight hours before your 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 your femoral artery. The catheter is guided through your body’s circulatory system using X-rays.
When the catheter reaches the location of the abnormality to be treated, material is injected to seal your blood vessel. A number of different materials may be used, including:
- glues that are biologically inert, which means they don’t interact with your tissues
- tiny plastic particles that lodge tightly in your blood vessel
- metal coils
- surgical balloons
The type of material your surgeon uses will depend on the problem that’s being treated.
The risks associated with this procedure include:
- recurring symptoms
- bleeding into your brain
- bleeding at the site of your incision
- damage to the artery where the catheter is inserted
- failure of the blocking material
- an infection
- a stroke
This procedure is sometimes performed under general anesthesia. Anesthesia can have risks beyond those inherent in EE. Some potential but rare risks of anesthesia include:
- temporary mental confusion
- a heart attack
- a lung infection
- a stroke
You’ll probably need to stay in the hospital for one or two days. You may need to stay 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.
Your outlook depends on the condition being treated. Brain damage caused by bleeding before, during, or after the procedure may not be reversible. The goal is to prevent damage, but AVMs and other malformations sometimes aren’t discovered until they’ve already begun to bleed.
Most often, EE is successful and has a good outcome. It can reduce your risk of bleeding from a burst aneurysm or other venous malformation. It can also decrease pain from tumors and make nosebleeds less frequent.