EMBOLISATION

Introduction

Embolisation is the medical term that describes a procedure to block blood vessels.

It is used in many fields of medicine, from the brain to the treatment of prostate issues in men and fibroids in women.

It is also a treatment option for Varicoceles, Pelvic Congestion Syndrome and for some Vascular Malformations.

The procedure involves the introduction of an embolic agent, that is a substance or device that effectively blocks the blood vessel.

There are four main types of agents:

Coils

Coils are miniscule fibres made of metal (generally either stainless steel or platinum) which are introduced into the blood vessel and remain in place. They are mainly used to treat aneurysms and internal bleeding.

Foam

Also referred to as 'gelfoam', is used to treat bleeding from trauma (or after giving birth). The main advantage of foam is that it generally dissolves within a few months of application.

Medical Superglue

Medical superglue is a medical grade version of standard 'superglue', which is used for a number of medical procedures.

Particles

Also referred to as 'beads' or 'spheres', these are introduced permanently and are used in the treatment of a range of conditions requiring blood flow to be blocked in very small vessels.

Preoperative Instructions

You should not eat or drink anything after midnight on the night before the procedure, although any medication you take regularly may be taken after this time with a small sip of water.

If you use blood thinning medication, you may need to stop taking these ahead of the procedure (please contact us if this is the case).

You should let us know if you show signs of infection (e.g. a cold or flu) before the procedure or if you are receiving treatment for an infection.

Procedure

An embolisation procedure may take approximately 60 minutes and is generally performed under sedation and a local anaesthetic. As the procedure is 'minimally invasive', a general anaesthetic is often not required.

A very thin plastic tube (a 'catheter') is introduced into a vein (either in the groin, neck or arm) and is moved gently to the site of the embolisation using x-ray guidance. An injection of contrast dye allows visualisation of the vessel structure on x-ray and the embolising agent is then introduced into the targeted vein/s.

Once this is complete the tube is removed, and the insertion site closed. A hospital stay is generally not needed and patients are only required to stay for 1-2 hours after the procedure until the effects of any sedation have worn off.

Postoperative Instructions

Normal activities can be resumed the day after the procedure. Patients are advised to avoid any exercise or any heavy lifting for 5-7 days.

In the case of treatment for Pelvic Congestion Syndrome sexual intercourse should also be avoided for 2-3 days. After embolisation, for Varicoceles it is normal to have a dull ache in the lower back or groin for a few days, which can be treated with pain relief medication. Patients can also experience a very low-grade discomfort for several months before healing is complete.

Risks

Allergic reaction to the contrast dye.

Damage to blood vessels.

Bruising/bleeding at catheter insertion site.

Embolising agent lodging at the wrong site and depriving other tissue of blood supply.

Failure of embolising agent.

Infection.