Embolization

Embolization is a general term for closing off or occluding a blood vessel. In most cases the vessel being closed is abnormal, though in some it may be normal but not absolutely necessary for normal function. It is generally done in cases of poorly controlled bleeding, or to reduce bleeding prior to a surgical procedure and occasionally to cure a lesion of the blood vessels. Most common conditions embolizations are performed for are tumors with a lot of blood vessels of the head, neck or spine; uncontrolled nosebleed; or abnormal connections between arteries and veins. 

A catheter is placed into an artery in your groin or wrist and directed under an x-ray camera to the vessels that need to be closed. Typically, a smaller catheter is positioned into the vessel as close to the site of occlusion (closure) as possible. Material is then injected or advanced through the smaller catheter to achieve vessel closure. The material may be small coils, small particles or a liquid material that hardens in the vessel. This is generally done using sedation or anesthesia.  

All medical procedures have risks. The risks of embolization can include bleeding of the vessel in the groin area or wrist. Less common is closing off a vessel that goes to a vital structure or organ that is causing symptoms. In the head and neck area, stroke is the most concerning, as the vessels are all connected to branches that go to the brain. Nerves that come out at the base of the skull or spine could also become injured by loss of blood supply. These nerves control motor and sensory function to the face and eyes, as well as vision. In some cases, a very long procedure could also lead to radiation injury, leading to loss of hair or skin burns.  

As with any medical procedure, you should talk to your doctor about the risks versus the benefits of the procedure.

If anesthesia or sedation is planned, you may not eat or drink for at least six hours prior to the beginning of the procedure. X-ray dye is used to map the blood vessels, so if you have a history of allergy to x-ray dye, you will need to start pretreatment medications the day before your procedure. Most embolizations can be done with a short stay admission or the day before a planned surgery for tumor removal.

Some pain at the site of puncture is common and usually eases after 2 – 3 days, but may persist for up to a month. If your embolization involves normal vessel closure such as in nosebleed cases, you may experience some pain in you face related to insufficient blood to muscles used to chew. In the first two weeks following this type of procedure, you should avoid foods that require a lot of chewing.