What is embolization?

Embolization is a minimally invasive procedure in which a doctor uses coils, glue, chemical agents or very small particles called polyvinyl alcohol particles to close (occlude) specific blood vessels (veins or arteries). The purpose of the procedure is to block blood flow to a specific area. It is used to treat a wide variety of conditions, including:

• aneurysm
• AVM (arteriovenous malformations)
• JNA (juvenile nasopharyngeal angiofibroma)
• uncontrollable bleeding due to trauma
• varicocele
• vascular malformations

In addition, we sometimes use embolization before a surgery, to minimize bleeding during the procedure.

How is embolization performed?

Using ultrasound and live X-ray for guidance, the doctor will insert a small guide wire and catheter through a blood vessel (usually in the groin area or the arm) and direct it to the area of interest. Then X-ray dye (contrast) will be injected and images taken to confirm catheter placement.

The doctor will then inject particles, coils, glue or chemical agents into the blood vessel through the catheter. If more than one blood vessel supplies the area to which we are trying to block flow, the doctor will move the catheter to those blood vessels and inject more of the embolization material.

Finally, the doctor will inject more X-ray dye and look at the movement of the dye on live X-ray (fluoroscopy) to determine if blood flow has been adequately blocked. When we obtain all the images, the catheter will be removed and we will place a bandage over the insertion site.

Will my child be awake for the procedure?

No. Depending on your child’s medical history, we will use either intravenous sedation or general anesthesia so that your child is asleep.

What risks are associated with the procedure?

The procedure is considered low risk. However, potential complications include:

• bleeding
• infection
• tenderness, bruising or swelling where the catheter was inserted
• numbness or coolness in the arm or leg
• injury to the blood vessels
• nontarget-site embolization
• puncture-site thrombosis (blood clot)
• stroke
• blindness (rare)
• allergic reaction to the X-ray dye (contrast reaction)
• reduced kidney function (due to the X-ray dye)
• post-embolic syndrome (fever, nausea and pain related to decreased blood flow in the treated area)

What happens after the procedure?

Your child will be monitored for six hours in our recovery area and may be admitted to the Hospital for observation. It is very important that your child keep the arm or leg that was punctured straight and still during that time to minimize risk of bleeding.

When can my child bathe?

The bandage must stay dry and in place for 48 hours. You may sponge bathe your child during this time, as long as the bandage stays dry. After 48 hours you may remove the clear bandage and gauze and your child can take a shower or a bath, as long as the site isn’t immersed in water. Leave the Steri-Strips® (white strips) in place; if they haven’t fallen off after seven days, you may remove them. Do not immerse the site in water until the Steri-Strips are off.

Are there any activity restrictions?

Your child will need to avoid strenuous activities, particularly contact sports or rough playing, for one week.