by Scholten A
(Endovascular Coiling)

Definition

Endovascular coil embolization is a procedure to fill or close blood vessels. This prevents bleeding and rupture. It is an alternative to open surgery.

Reasons for Procedure

Endovascular embolization can treat many conditions such as:

Brain Aneurysm
IMAGE
An aneurysm is a weakened blood vessel in the brain that collects blood. The bulging, blood-filled pocket can put pressure on parts of the brain, pressing on nearby nerves. This can cause symptoms or cause the blood vessel to rupture (hemorrhage).
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Possible Complications

Problems are rare, but all procedures have some risk. Your doctor will talk about possible problems such as:

  • General:
    • Problems from anesthesia or imaging contrast dye
    • Infection
    • Blood clots
    • Damage to other organs or structures
  • Treating brain lesions may cause:
    • Weakness, numbness, or tingling
    • Problems with speech, vision, thinking, or memory
    • Seizures

Things that may raise the risk of problems are:

What to Expect

Prior to Procedure

The care team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Tests that will need to be done before the procedure

Anesthesia

The doctor will give general anesthesia. You will be asleep.

Description of the Procedure

A tiny incision will be made in the groin to access an artery. A thin, hollow tube (catheter) will be placed in the artery. It will be threaded up to the site. A special dye is injected. It makes it easier to see on a video monitor. X-rays will help the doctor find the right place. The blood vessel can be closed with:

  • Medicines
  • Coils
  • Stents
  • Other man-made material

They are inserted though the catheter and to the site. Imaging tests will confirm the blood vessels are closed. The catheter will be removed. The incision will be closed and bandaged.

How Long Will It Take?

30 minutes to several hours—the time depends on what needs to be done

Will It Hurt?

Anesthesia will prevent pain during surgery. Medicines will ease pain after.

Average Hospital Stay

Normally, the length of stay is 2 days. If there are problems, you may need to stay longer.

Post-procedure Care

At the Hospital

During your stay, the healthcare staff will take steps to lower your risk of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered.

There are also steps you can take to lower your risk of infection such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incision
At Home

Recovery may take a few weeks. Some activities may be limited during this time. You may also need physical therapy.

Call Your Doctor

Call your doctor if you have:

  • Fever or chills
  • Redness, swelling, excess bleeding, or discharge from the incision site
  • Lasting nausea or vomiting
  • Pain that you cannot control with the medicines
  • Problems with thinking, balance, or movement
  • Weakness, numbness, or tingling
  • Headaches, fainting, vision problems, or problems passing urine or stool (poop)
  • Pain, swelling, or cramping in your legs

Call for medical help right away for:

  • Seizures
  • Problems breathing
  • Chest pain

If you think you have an emergency, call for medical help right away.

RESOURCES

Brain Aneurysm Foundation  https://www.bafound.org 

National Institute of Neurological Disorders and Stroke  https://www.ninds.nih.gov 

CANADIAN RESOURCES

Brain Injury Canada  https://www.braininjurycanada.ca 

Heart and Stroke Foundation  http://www.heartandstroke.ca 

References

Catheter embolization. Radiology Info—Radiological Society of North America website. Available at: https://www.radiologyinfo.org/en/info.cfm?pg=cathembol. Accessed September 6, 2021.

Endovascular (embolization) treatment of aneurysms. The Toronto Brain Vascular Malformation Study Group website. Available at: http://brainavm.oci.utoronto.ca/malformations/embo%5Ftreat%5Faneurysm%5Findex.htm. Accessed September 6, 2021.

Rinkel GJE. Management of patients with unruptured intracranial aneurysms. Curr Opin Neurol. 2019;32(1):49-53.

Splenic artery aneurysm (SAA). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/splenic-artery-aneurysm-saa. Accessed September 6, 2021.

Vascular malformations in the brain. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/vascular-malformations-in-the-brain. Accessed September 6, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Nicole Meregian, PA
  • Review Date: 07/2021
  • Update Date: 09/06/2021