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Endovascular Embolization of Cerebral Aneurysm

Authors:
  • Cynthia M. Johnson, MA
Publication Type:

Procedure

Endovascular Embolization of Cerebral Aneurysm

(Endovascular Coiling of Cerebral Aneurysm)

Definition

Endovascular embolization is a procedure that blocks blood flow in a specific area. In this case, it blocks blood flow through a weakened artery in the brain.

Reasons for Procedure

This procedure is done to manage an aneurysm. This is a weakened spot in the wall of the artery. It may cause bleeding or burst. The embolization will decrease the risk of this happening.

Possible Complications

Problems are rare, but all procedures have some risk. Your doctor will go over some problems that may happen, such as:

  • Infection
  • Allergic reactions to anesthesia
  • Stroke due to a blood clot
  • Seizures
  • The aneurysm is punctured and bursts
  • The aneurysm is not fully closed and problems return

Thing that may raise the risk of problems are:

  • Smoking
  • Drinking alcohol
  • Long term health issues such as high blood pressure or kidney disease

What to Expect

Problems to Look Out For

Call your doctor if you have:

  • Signs of infection, such as fever or chills
  • Redness, swelling, pain, bleeding, or discharge from the incision
  • Pain that you cannot control with the medicine you were given
  • Pain, swelling, cramping, or loss of feeling in your legs
  • Chest pain
  • Lightheadedness

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

Prior to Procedure

The surgical 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
  • Specialists you may need to see
  • Tests that will need to be done before surgery

A ruptured aneurysm is an emergency. The procedure may need to be done right away.

Prior to Procedure

The surgical 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
  • Specialists you may need to see
  • Tests that will need to be done before surgery

A ruptured aneurysm is an emergency. The procedure may need to be done right away.

Anesthesia

The doctor may give:

  • Moderate sedation—you will be but sleepy and will not feel pain
  • General anesthesia—you will be asleep

Description of the Procedure

An incision will be made in your groin. A hollow needle will be inserted into your artery. A long tube will be passed through the needle. An x-ray machine will show the doctor where the tube is in your body.

The tube will be guided through the artery, past the heart, and into the brain. A dye will highlight the blood vessels and blood flow. A second tube will be placed in the first one and guided to the aneurysm. Coils will be guided through the tube and inserted into the area. A blockage will naturally form over the coil. It will stop blood flow to the weak artery. Some aneurysms may need a metal tube called a stent to hold the coils in place.

The doctor will check to make sure blood is no longer flowing into the aneurysm. The tube will be taken out. A seal may be placed over the puncture site to close it. A bandage will be put on the incision.

Immediately After Procedure

You will need to lie flat for 2 to 6 hours.

How Long Will It Take?

It will take 2 to 4 hours.

How Much Will It Hurt?

Anesthesia will block pain during the procedure. You may have some discomfort when the tube is first inserted. The area will be sore for a few days.

Average Hospital Stay

A person with an unruptured aneurysm will stay in the hospital overnight. A person with an aneurysm that ruptured will need to stay longer.

Post-procedure Care

At the Care Center

The staff will check on your progress until the anesthesia wears off.

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

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incision covered

You can also lower your chances of infection by:

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

At Home

Strenuous activities will need to be limited for two weeks.

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References

  • Brott, T.G., Halperin, J.L., et al. 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: executive summary. Stroke, 2011; 42 (8): e420-e463. Correction can be found in Stroke, 2011; 42 (8): e541.
  • Carotid angioplasty and stenting. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/carotid-angioplasty-and-stenting.
  • Carotid artery disease: carotid stenting. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/treatments/16850-carotid-artery-disease-carotid-stenting.
  • Carotid artery stenting. British Society of Interventional Radiology website. Available at: https://www.bsir.org/patients/carotid-artery-stenting.
  • Carotid artery stenosis repair. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/carotid-artery-stenosis-repair.
  • Carotid stenting. UCSF Department of Surgery website. Available at: https://surgery.ucsf.edu/conditions--procedures/carotid-stenting.aspx.
  • Endovascular angioplasty with stenting (CAS). Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/cerebrovascular/treatment/carotid_angioplasty_with_stenting.html.

Contributors

  • Michael J. Fucci, DO, FACC
Last Updated:
2023-06-01

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.