Embolization for Brain Aneurysm
Embolization is a procedure used to treat a brain aneurysm. A brain aneurysm is a balloon-like sac or bulge in the wall of a brain artery. If the aneurysm bursts (ruptures) and bleeds, nearby brain tissue may be damaged. This can cause a stroke, which can be fatal. Embolization may be done before an aneurysm bursts, to prevent these problems. It can also be done after an aneurysm has burst. The procedure involves putting a substance (metal coils, or specialized particles or liquid) inside the aneurysm. This helps to seal the aneurysm, and stop it from bleeding or rupturing.
Getting ready for your procedure
Embolization may be done as an emergency procedure after an aneurysm has burst. You or a family member should tell your healthcare provider if you:
Are pregnant or think you may be
Are allergic to X-ray dye (contrast medium) or other medicines
Also tell your provider about any medicines you are taking. You may need to stop taking all or some of these before the procedure. This includes:
All prescription medicines
Over-the-counter medicines such as aspirin or ibuprofen
Herbs, vitamins, and other supplements
Follow any directions you’re given for not eating or drinking before the procedure.
Follow any other instructions your provider gives you to get ready.
During your procedure
The procedure usually takes about 1 to 2 hours. In general, you can expect the following:
You will be given medicine (anesthesia) to stop you from feeling pain during the procedure. You may be given general anesthesia. This puts you into a state like a deep sleep through the procedure. Or you may be given sedation with local anesthesia instead. Sedation makes you relaxed and sleepy. Local anesthesia numbs the areas to be worked on.
For the procedure, a long, thin tube (catheter) is used. A small cut (incision) is made at the site where the catheter will be inserted. This is most often in the groin. The catheter is then passed through the incision and placed into an artery in the groin. The catheter is moved up through the artery to the brain.
X-ray dye is sent through the catheter. This makes it easier to see the artery and catheter on X-ray images. The catheter's movement can be seen on a video monitor.
The catheter is used to place a substance into the aneurysm. The substance may be thin metal coils, or specialized particles or liquid. This causes a blood clot to form in the aneurysm. This clot seals the aneurysm and prevents it from bleeding.
When the procedure is complete, the catheter is removed.
After your procedure
You’ll need to lie still for 4 to 6 hours after the procedure. Pressure may be applied to the site to help reduce the risk of bleeding. Once you are stable, you’ll be moved to a hospital room. You may need to stay in the hospital overnight if the aneurysm was not yet ruptured. If the aneurysm ruptured and caused a stroke, you will stay in the hospital until you recover. This may be for 1 to 4 weeks. It depends on how much damage the aneurysm caused. While you’re in the hospital, more imaging tests will be done. They will show exactly where the substance was put in the aneurysm. The tests also help check that there is no more bleeding.
Risks and possible complications
All procedures have some risk. Possible risks of embolization include:
Bruising, bleeding, or infection at the catheter insertion site
Swelling or bleeding in the brain
Short-term (temporary) or long-term (permanent) neurologic problems related to stroke. These may include weakness, paralysis, confusion, and loss of vision, speech, or memory.
Problems due to X-ray dye, including allergic reaction or kidney damage
Damage to an artery
More treatment or surgery. This may be needed if treatment is incomplete or an aneurysm occurs again.
May 20, 2017
Treatment of cerebral aneurysms, Up To Date
Fetterman, Anne, RN, BSN,Sudheendra, Deepak, MD