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Embolization

AMBULATORY CARE:

What you need to know about embolization:

Embolization is a procedure to create a clot, or block, in a blood vessel. This stops blood from flowing to the area. The procedure may be used to treat many conditions. It can help stop heavy bleeding (hemorrhage), or prevent an aneurysm from rupturing. An abnormal connection between arteries can be removed. Embolization can stop blood flow to a tumor, such as a uterine fibroid or a cancer tumor. Chemotherapy medicine may be given during an embolization to treat a cancer tumor. This is called chemoembolization.

How to prepare for the procedure:

Embolization is sometimes done as an emergency procedure. This means you will not have time to prepare. For an embolization that is not an emergency, the following are general guidelines for how to prepare:

  • Tell your provider about all your allergies. This includes if you have ever had an allergic reaction to contrast liquid, anesthesia, or antibiotics. You may be told not to eat or drink anything after midnight the night before your procedure. Arrange to have someone drive you home. The person should stay with you to help you and watch for problems that may develop.
  • Give your provider a list of your medicines. Include all medicines and supplements you take. You may need to stop taking blood thinners or aspirin several days before your procedure. This will help decrease your risk for bleeding. Do not stop taking medicines unless your healthcare provider tells you to stop. Your provider will tell you which medicines to take or not take on the day of your procedure.
  • You may need blood tests to check how well your blood clots and to check your kidney function. Depending on the reason for this procedure, you may an MRI, ultrasound, x-ray, or CT scan. These pictures will help your healthcare provider examine the area to be worked on.
  • If you are a woman, tell your provider if you know or think you might be pregnant. You may not be able to have certain tests because they may harm an unborn baby. Your provider may need to take extra precautions for other tests.

What will happen during the procedure:

  • You may be given general anesthesia to keep you asleep and pain-free. You may instead be given moderate sedation. This means you will be awake during the procedure, but you should not feel any pain. Your provider will put numbing medicine on your skin where the procedure will be done. A small incision will be made over an artery. A catheter (thin tube) will be guided into the artery. Contrast liquid will be used to help your healthcare provider see your arteries more easily.
  • Your provider will use a type of x-ray that gives a moving picture of the arteries. This will help him or her move the catheter into the right place. The catheter is moved up until it reaches the correct artery. Your provider will put medicine or a material into the artery to slow or stop blood from flowing. This may be a coil, foam, beads, a plug, or liquid. The liquid may also contain material that is larger than blood cells.
  • Your provider will remove the catheter. Pressure will be used to stop any bleeding that happens. The incision area does not need to be closed with stitches. It will be small and close on its own. It will be covered with a bandage to keep it from becoming infected.

What to expect after the procedure:

  • You may have pain for a few days. Depending on the reason you had this procedure, you may also have a headache or cramps. You may have pain, bleeding, or bruising where the catheter went into your leg. All of these symptoms are normal and should get better soon. You may be given pain medicine through your IV or a pump. A pump allows you to control when the pain medicine is given.
  • You should expect to stay in the hospital at least overnight. If you had this procedure to treat heavy bleeding, it may take 24 hours to know if the bleeding stopped.
  • Healthcare providers will help you walk around after your procedure. This will help prevent blood clots. Do not get up until healthcare providers say it is okay. They may want you to lie in one position for a certain amount of time. When they say it is okay to walk, they will help you stand and walk safely.

Risks of embolization:

You may bleed more than expected or develop an infection. The area being treated may be damaged during the procedure. Your artery may be damaged from the catheter, or you may develop a blood clot. Your kidneys may be damaged from the contrast liquid. The material being put into the artery may go to the wrong place. This can stop blood flow to healthy tissue. The procedure may not work, or it may not relieve your symptoms.

Call your doctor or specialist if:

  • You have a fever higher than 100.4°F (38°C).
  • You have a fever, pain, and nausea that last longer than 3 days.
  • You suddenly have severe abdominal pain.
  • You cannot urinate, or you urinate very little.
  • You have signs of an infection at the catheter site, such as red streaks, pain, or swelling.
  • You have new or worsening pain.
  • You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

  • NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Self-care:

  • Rest as needed. Rest and sleep will help your body heal.
  • Follow your healthcare provider's instructions for activity. He or she will tell you when it is okay to return to your normal activities and to start driving. He or she may want you to wait 1 to 2 weeks to return to work.
  • Care for the catheter site as directed. It is okay to shower after the procedure. You will only have a small cut in your skin from where the catheter went into your leg. Check the catheter site for signs of infection, including red streaks, pain, and swelling.
  • Treat symptoms of postembolization syndrome. This syndrome is common after an embolization procedure. It usually starts within 72 hours of the procedure and may last a few days. The main symptoms are fever, pain, and nausea. You will probably be able to manage your symptoms at home. Acetaminophen or an NSAID, such as ibuprofen, can reduce a fever and pain. You may need to eat lightly to manage nausea. Drink more liquids for the first week after the procedure to prevent dehydration.

Follow up with your doctor or specialist as directed:

You may need to have more tests to check if the procedure worked. Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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