The Science of Endovascular Embolization

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What is endovascular embolization?

Endovascular embolization, abbreviated EE, is a type of surgical procedure. More specifically, endovascular embolization is an invasive surgical procedure. The main purpose of an endovascular embolization is for the treatment of abnormal blood vessels in the brain. It is also used to treat abnormal blood vessels in other parts of the body.

Endovascular embolization is a major alternative to open surgery. With this procedure, a surgeon can cut off blood supply to an affected area of the body by blocking the vessels that supply that area.

Doctors usually recommend endovascular embolization if their patient experiences any of the conditions listed below:

• Tumors, like uterine fibroids. Blocking the blood flow to a fibroid can help to shrink it.
• Brain aneurysms: These are enlarged weak spots in the walls of blood vessels supplying the brain.
• Nosebleeds
• Arteriovenous malformations of the spine and brain: knots of blood vessels that are heavily susceptible to bleeding.
• Unhealthy growths in your circulatory system

Endovascular embolization may serve as the first line of treatment in some cases, or it may be done before another surgery. Blocking the supply of blood to an infected, or damaged part of the body can make increase your chances of having a successful surgery.

How to prepare for an endovascular embolization

Most cases of EE are often an emergency. So, you won’t have much time to prepare. However, if it is not performed as an emergency, you can take the following steps:

• Disclose to your doctor any medications that you’re currently taking, or have taken in the past. These include over-the-counter, prescription, and herbal medications.
• If you drink alcohol regularly, make sure you tell your doctor.
• Avoid smoking or reduce the rate at which you do so.
• Do not eat or drink anything at least 8 hours before your surgery
• Make arrangements with a loved one or a friend to drive you home after the surgery.

How is endovascular embolization done?

The procedure is carried out in a hospital. During an EE, your surgeon will make a small incision in the groin area.

After making the incision, a catheter is inserted through your femoral artery. The femoral artery is a large blood vessel in the leg. The surgeon will use x-rays to guide the catheter through your circulatory system.

When the catheter arrives at the part to be treated, your doctor will inject a substance to seal your blood vessel. Several materials may be injected, including:

• Biologically inert glues. By “biologically inert,” it means that these materials don’t interact with your body tissues.
• Foam
• Surgical balloons
• Metal coils
• Tiny particles made of plastic. When injected, they will lodge in your blood vessel.

The substance injected by your surgeon depends on your condition.

Risks associated with EE

There are a few risks associated with endovascular embolization. They include:

• Bleeding in the brain
• Recurring symptoms
• A stroke
• An infection
• The blocking substance may fail to work as it should
• Bleeding at the site where the incision was made

Most of the endovascular embolizations are carried out under general anesthesia. Anesthesia does have its risks, including:

• A heart attack
• Mental confusion (temporary)
• Stroke
• Death

Outlook

You may not go home immediately after the surgery. You may spend up to 2 days in the hospital after surgery. If there’s bleeding, then you may have to stay longer in the hospital.

How fast you recover depends on your health status at the time of the surgery. Any underlying medical condition can also affect the rate at which you recover.

Your prognosis depends on the condition being treated. If a patient has brain damage caused by bleeding due to the procedure, it may be irreversible.

Preventing damage should be a priority. But the thing is, arteriovenous malformations are usually not discovered until the bleeding has begun. Most endovascular embolization procedures are successful, with an excellent prognosis. It reduces the risk of bleeding from a burst aneurysm. It also reduces pain caused by tumors, as well as nosebleeds.