Background Information:

What are the other Names for the Procedure?

• Embolization using Catheter

What is Catheter Embolization radiology procedure? (General Explanation)

• In Catheter Embolization, embolic agents are placed in a catheter as the catheter is placed into a blood vessel, in order to block blood vessels and prevent blood flow to the area
• Embolic agents are agents, which are placed or delivered into blood vessels, so as to block or stop the flow of blood to a particular part/region of the body

What part of the Body does the Procedure involve?

A Catheter Embolization may be performed in the following body parts:

• Brain
• Uterus
• Gastrointestinal tract
• Any area with arteriovenous malformation

Why is the Catheter Embolization radiology procedure Performed?

• The purpose of the Catheter Embolization procedure is to prevent or control bleeding that result from injuries, trauma, gastrointestinal problems, ulcers, and heavy menstrual periods due to fibroid tumors
• This procedure can be a good alternative to hysterectomy (surgical removal of the uterus)
• Catheter Embolization can be used in arteriovenous fistula (abnormal connections between artery and veins) and arteriovenous malformation, to prevent diversion of blood away from vital organs, such as brain and spinal cord
• Aneurysms are sacs formed due to weak arterial walls and varicoceles are enlarged veins in the scrotum. These conditions can be treated using Catheter Embolization
• To occlude blood flow to the tumor, to shrink the tumors, before chemotherapy or surgical procedures

What is the Equipment used? (Description of Equipment)

The following equipment may be used for Catheter Embolization procedures:

• A catheter
• X-ray equipment
• Embolic agents
• An examination table
• Fluoroscopy is used to convert x-ray images into video images

What are the Recent Advances in the Procedure?

There have been no recent advances to replace the Catheter Embolization procedure.

What is the Cost of performing the Catheter Embolization radiology procedure?

The cost of the Catheter Embolization procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion prior to Procedure?

• It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding Catheter Embolization procedure and what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
• Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.radiologyinfo.org/en/info.cfm?pg=cathembol (accessed on 08/02/2014)

Prior to Catheter Embolization radiology procedure:

How does the Catheter Embolization radiology procedure work?

The Catheter Embolization works in the following manner:

• Contrast materials and x-ray machines are used to visualize the blood vessels
• A catheter is inserted into the blood vessel and sent to the site of procedure/treatment
• Once the catheter reaches the site of treatment, embolic agents are injected into the concerned site/region (that may be an abnormality, injury, ulcer, etc.)
• The embolic agent blocks blood flow to the site/region

How is the Catheter Embolization radiology procedure Performed?

• An ultrasound, MRI, or CT scan may be performed during the Catheter Embolization procedure, to check the problem area or abnormality
• The patient is positioned on the examination table and the site of catheter insertion is cleaned and sterilized
• The nurse inserts an intravenous (IV) line into the patient’s arm to give sedative medication, during the procedure
• A catheter is inserted into the clean area and sent to the treatment site
• Contrast materials are injected through the catheter; the X-ray machine is used to visualize the site of abnormality
• Embolic agents are sent to the concerned site, by injecting them through the catheter
• Both the catheter and IV lines are removed at the end of the procedure

For treatment of intracranial arteriovenous malformation (AVM), only a small amount of embolic agent is first injected. Then, neurological tests are done, to ensure that the embolization will not affect important regions of the brain.

Where is the Procedure Performed?

• A Catheter Embolization procedure is performed as an outpatient procedure, at a hospital
• If the procedure is used for an aneurysm that is ruptured, then the patient would have to stay in the hospital for a few days

Who performs the Procedure?

Catheter Embolization is performed by interventional radiologists and interventional neuroradiologists.

How long will the Procedure take?

The Catheter Embolization procedure may take 30 minutes to several hours, depending upon the type of treatment. The patients may be required to stay in bed for several hours.

Who interprets the Result?

An interventional neuroradiologists interprets the results of the Catheter Embolization procedure and inform the primary care physician, to set-up a follow-up care with the patient.

What preparations are needed, prior to the Procedure?

The following preparations may be needed prior to a Catheter Embolization procedure:

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are being currently taken
• Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
• The physician may recommend the patient to stop taking NSAIDs (non-inflammatory drugs), aspirin, or blood thinners, before the procedure
• Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material, which may be used in the procedure
• It is advisable to wear comfortable and loose clothes. Avoid wearing any metal objects or jewelry, as it may interfere with the X-ray
• It is highly recommended to inform your healthcare professional, if you are pregnant or breastfeeding
• The patient must avoid eating or drinking at least 8 hours prior to the procedure, depending on when the procedure is arranged
• The patient will need to be admitted to the hospital and shall be required to stay overnight at the hospital

What is the Consent Process before the Procedure?

A physician will request your consent for the Catheter Embolization procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied with the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of the Catheter Embolization procedure:

• Embolization is a much less complicated procedure than an open surgery. It requires significantly lesser hospital stay and leads to much lesser complications
• The procedure is very effective in controlling bleeding, particularly in emergency situations
• The procedure can be used very effectively in the treatment of uterine fibroids, tumors, and vascular malformations

Following are the benefits of the Catheter Embolization procedure:

• The catheter used in the procedure may damage blood vessels, in some cases
• Any insertion made into the skin (for the catheter or IV line) may increase the chances of an infection
• Contrast materials used in the procedure may cause allergic reactions in some patients. Contrast materials may also damage the kidney, especially in diabetic patients or in those with kidney disease
• Embolization may damage the uterus in some patients, when used in uterine fibroid embolization
• Embolic agent may lodge at the wrong place and stop blood supply to that region

What are the Limitations of Catheter Embolization radiology procedure?

• The Catheter Embolization procedure requires a very precise placement of catheter. It cannot be used in some cases, where it is not possible to precisely place the catheter
• In some cases, such as with arteriovenous malformation (AVM), several embolization procedures may be needed to reduce the symptoms

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

• What is the Catheter Embolization procedure?
• Why is this procedure necessary? How will it help?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place, during recovery?
• What are the possible side effects from the procedure? How can I minimize these side effects?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any lifestyle restrictions or modifications required, after the procedure is performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
• Is there any medication that needs to be taken for life, after the procedure?
• What are the costs involved?

During the Catheter Embolization radiology procedure:

What is to be expected during the Catheter Embolization radiology procedure?

The following may be expected during a Catheter Embolization procedure:

• The patient will feel a slight pin prick, when the needle is inserted for the IV line
• A slight pressure and discomfort may be experienced, when the catheter is inserted
• The patient may experience a warm feeling, when the contrast material is injected
• Usually, local anesthesia is administered. If the patient is administered general anesthesia, then they remain unconscious throughout the procedure
• Sedatives may be used in the procedure to help the patient relax

What kind of Anesthesia is given during the Procedure?

The patient is given local or general anesthesia for the Catheter Embolization procedure.

How much Blood will you lose, during the Procedure?

There is no much blood loss involved, during the Catheter Embolization procedure.

What are the possible Risks and Complications during the Catheter Embolization radiology procedure?

The risks of the Catheter Embolization procedure may include:

• In some cases, the Catheter Embolization procedure may cause the following:
  • Pneumothorax
  • Blood clots
  • Dislodging of the tube
  • Injury to the chest wall or lungs
• There is a risk of infection, as the skin is penetrated during placement of the IV line and insertion of the catheter 

What Post-operative Care is needed at the Healthcare Facility after the Catheter Embolization radiology procedure?

Generally, there is no postoperative care necessary after a Catheter Embolization procedure, at the healthcare facility. However, this is dependent upon the reason for performing the procedure.

After the Catheter Embolization radiology procedure:

What is to be expected after the Catheter Embolization radiology procedure?

The following may be expected after a Catheter Embolization procedure:

• Side effects of embolization could be painful; however, it can be controlled through medications
• Women undergoing this procedure for fibroid tumors may experience cramps or severe pain, after the procedure
• About 20% of the patients may experience post-embolization syndrome, in which they may develop fever, loss of appetite, nausea, or vomiting. This syndrome is more common when solid, large tumors are embolized; though, the symptoms mostly resolve within 3 days

When do you need to call your Physician?

• If there is a skin infection after the Catheter Embolization procedure, or if the patient is feeling ill again, then they should immediately notify the physician
• If the patient experiences an allergic reaction to the anesthesia, then he/she should notify the physician immediately

What Post-operative Care is needed at Home after the Catheter Embolization radiology procedure?

The following post-operative care may be required at home, after a Catheter Embolization procedure.

• Avoid any heavy-lifting or strenuous exercises for the next 24 hours
• Take adequate rest for the next 24 hours or more (per advice of the physician)
• Take the prescribed medications

How long does it normally take to fully recover from the Procedure?

• The patient may resume their daily activities after 24 hours, in most cases. This may take longer, in case of aneurysms that have ruptured
• Headaches may result after the Catheter Embolization procedure; these may last from 7 days to 6 months
• Most individuals return to their normal activities after one month; they may also begin to drive after 3 months (per advice of the physician)

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

No tissue is extracted from the patient during a Catheter Embolization procedure.

When should you expect results from the pathologist regarding the tissue taken out during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from after the Catheter Embolization radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The hospital, where the procedure is performed
• A radiologist or neurologist, performing the procedure
• Healthcare providers, physicians, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Catheter Embolization procedure is performed.