Embolization – Arteriovenous Malformation (AVM)
Why is this procedure done?
Embolization is a general term for closing off or occluding a vessel. In most cases, the vessel being closed is abnormal, though in some it may be normal but not absolutely necessary for normal function. Embolization for arteriovenous malformation ( (AVM) ) is done either to close off the abnormal blood vessels as the treatment or before surgery to help decrease the number of vessels the surgeon must address.
How is embolization done?
Endovascular embolization is a treatment where 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.
What are my risks? What are common complications?
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 possible complication, 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 with your doctor about risks versus benefits of the procedure.
What do I need to know before 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.
General discharge instructions.
Your case may require more restrictions than those listed below. Talk with your healthcare provider about your specific instructions.
- You may resume regular activities, including driving, in 24 hours, unless you have been restricted for another reason.
- If you take Glucophage (metformin or metformin products), do not take it for two days after the angiogram; on the third day, start again as prescribed.
- No exercising, lifting objects greater than 10 pounds or strenuous activity for the first five days after procedure.
- Do not soak the puncture site for two weeks (no tub bathing, swimming or getting in the hot tub).
- Keep the site clean and dry.
- You may have soreness, a bruise or a knot near where the needle was inserted for your procedure for a few days to a few weeks. This is normal.
- Check the spot where the needle was put in for redness, pain, swelling and a lot of bleeding or drainage. Call us if this happens.
What should I expect while recovering?
Some pain at the site of puncture is common. This usually eases up after 2 – 3 days, but may persist for up to a month. Again, your condition may require surgery following the embolization, so your recovery may be different. Speak with your healthcare provider about this.