Embolisation

Embolisation involves introducing small catheters within the blood vessels to deliberately occlude vessels by introducing an embolising agent to produce vessel closure. 

The main reasons to embolise a vessel are:

• To control active bleeding - emergency
• Tumour embolisation - occlude the blood vessel supplying a tumour
• Fibroid embolisation - interrupting the blood supply to uterine fibroids will cause them to shrink or disappear completely
• Vascular malformation
• Aneurysms
• Varicoceole embolisation

There are many types of embolic agents that can used:

• Autogenous clot
  
  
• Gelfoam pledgets/powder - sterile gelatin sponge that may be applied to bleeding surfaces to stop bleeding. It is generally considered a temporary embolic and allows vessel recanalization in several days to several weeks
  
  
• Polyvinyl alcohol - is a permanent embolic agent that stimulates intraluminal thrombosis and an associated inflammatory reaction
  
  
• Microcoils - are made of platinum and, when deployed, function in a similar manner to a surgical ligation

You will need to fast for four hours before your appointment, this will ensure that your stomach is empty and eliminate the risk of aspiration (of fluid or food into the lungs).

Please go to the peri-operative department on the day of your procedure and the staff there will prepare you and perform a set of routine observations before coming to the interventional radiology department for your procedure.

Please continue to take all your regular medication with sips of water (unless otherwise instructed), including your blood pressure medication.

Please inform the clerk at the time of booking your procedure if you are currently taking medication that thins your blood (eg  Aspirin, Plavix, Warfarin)  as these may need to be stopped a few days prior to your procedure. It may be useful to bring a LIST of medications to your appointment.

You will need to have a blood test a few days prior to your appointment to assess your kidney function and blood clotting times. If your blood sample was taken outside the hospital then please obtain a copy of the results and bring it with you on the day of your procedure.

You will need to bring any previous films (x-ray/CT/MRI/US) along to your appointment.

It is important that you inform a member of staff as soon as possible if you are pregnant BEFORE the procedure is performed. If you suspect that you could be pregnant then you will need to have a pregnancy test at the hospital prior to the commencement of the procedure.

This procedure involves the use of intravenous contrast; see Intravenous Contrast

For health and safety reasons, family members cannot be present with you during the procedure. A staff member will be available to assist you at all times during the procedure if you have any concerns.

A doctor will explain the procedure beforehand and you will be required to sign a consent form. If you require an interpreter, please inform the booking clerk at the time of booking.

This procedure requires your groin area to be shaved. It is optional if you wish to personally attend to this prior to appointment.

You will be asked to remove your underwear and change into a hospital gown. All jewellery and metal objects in the area to be scanned will need to be removed as this can cause artefacts and obscure the images.

An IV cannula will be inserted into a vein in your arm. A set of routine observations will be taken before the procedure begins (blood pressure, heart rate, etc). A cold cleaning solution will be applied to clean the skin in your groin area and a sterile sheet will be placed over your body.

Local anaesthetic will be injected to numb the area around your groin. A needle will be inserted using ultrasound guidance into the common femoral artery in your groin. A soft wire is inserted through the needle into your artery and the needle is then replaced with a short plastic tube called a sheath. A catheter is then guided through your arteries until it reaches the area of interest.

X-ray pictures are taken while the contrast is injected into your arteries until the catheter reaches the blood vessels that need to be embolised. Embolic agents are then injected through the catheter and into the artery of interest with the aim of completely blocking off the artery. It may take several injections to ensure this.

Contrast will be injected throughout the procedure to continuously assess the blood flow through your arteries.

At the end of the procedure, the sheath will be removed and pressure applied on your groin area for about 10 to 15 minutes to stop bleeding.

You will then be transferred to the recovery area. Your vital signs, groin will be monitored regularly after the procedure for swelling, oozing of blood and bruising.  Moving too soon after the procedure may cause bleeding and bruising at the puncture site.

The cannula in your arm will be removed just before you leave the peri-operative department.

Go to your nearest Emergency Department or GP if you become unwell or have:

• A cool or cold limb
• Slurred speech, balance problems or trouble using your arm or leg
• Pain unrelieved by over the counter pain killers
• Continuous bleeding or swelling at the skin puncture site in your groin
• Signs of infection such as redness, inflammation at the puncture site or fever

 Staff will inform you what level of activity is suitable after your procedure.

A report regarding your procedure will be given to you before you leave to give to your referring doctor. It contains information about your procedure and any findings that your doctor should know about.

• Fasted (no food or drink) for four hours
  
  
• Recent Blood test
  
  
• Removed all Jewellery and metal objects

Don't forget to bring these along to your appointment

• Referral/request form from your doctor
  
  
• Medicare / Pension card
  
  
• Previous films and report