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Vascular malformations of the brain
A guide for patients and carers
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Embolisation
Embolisation is used to treat AVMs of the brain and AVFs of the dura. It involves injecting liquid glue, or sometimes inserting small metal coils, into the AVM using a long catheter similar to the one used for an angiogram. A highly trained interventional radiologist who has considerable experience with the technique will carry out the procedure.
Embolisation can sometimes block off the blood supply to an AVM and get rid of it completely but it usually at least succeeds in reducing the size of the AVM. Sometimes, it can also reduce symptoms such as noise in the head or headaches.
In some circumstances, embolisation is used to shrink an AVM so that it is suitable for radiosurgery or neurosurgery. It can also be used to reduce the risk of bleeding from the AVM during subsequent neurosurgery.
Unless embolisation is performed as an emergency, you will be admitted to hospital the night before so that routine blood tests can be carried out and you can be prepared for the procedure. You will not be allowed to eat from midnight before the embolisation. The neuroradiologists will discuss the procedure with you, explaining the risks and benefits, and you will be asked to sign a consent form.
On the day of the procedure, you will be taken to the radiology department. One or both of your groins might be shaved and you will be given a general anaesthetic.
The length of the procedure depends on the complexity of the tangle of blood vessels. Usually, it is a matter of hours. The neuroradiologists thread the catheter from your groin through the blood vessels up to the AVM and place it in a safe position close to the AVM before injecting the liquid glue. The glue hardens after it is injected into your AVM and blocks the flow of blood through the AVM.
You will need to keep your legs straight to prevent bleeding at the point where the catheter entered the blood vessel in your groin.
You will be observed closely by the medical team looking after you. Because there is a risk of stroke after embolisation, you should mention any unusual feelings if you develop them, although symptoms are likely to be short-lived. Many people experience a headache for a short while after the treatment. Normally, people go home within 48 hours of the procedure.
Some weeks or months after the embolisation, your doctors will want to repeat an angiogram to see how effective your treatment has been. If your AVM is large you might need to return for further embolisation treatment in stages over the following weeks or months.
If your AVM is not completely sealed, it still carries a risk of further bleeding. In this case, your doctors might decide to try one of the other possible treatments, if they are appropriate, in an attempt to get rid of the AVM.
Embolisation can be used to treat AVMs deep in your brain in areas that would be too difficult to reach during a craniotomy. However, it is less likely to seal off an AVM completely in just one go and you might need several separate sessions of treatment.
In some circumstances, embolisation is used to shrink an AVM so that it is suitable for radiosurgery or neurosurgery. It can also be used to reduce the risk of bleeding from the AVM during subsequent neurosurgery.
What happens before embolisation?
Unless embolisation is performed as an emergency, you will be admitted to hospital the night before so that routine blood tests can be carried out and you can be prepared for the procedure. You will not be allowed to eat from midnight before the embolisation. The neuroradiologists will discuss the procedure with you, explaining the risks and benefits, and you will be asked to sign a consent form.
On the day of the procedure, you will be taken to the radiology department. One or both of your groins might be shaved and you will be given a general anaesthetic.
What happens during embolisation?
The length of the procedure depends on the complexity of the tangle of blood vessels. Usually, it is a matter of hours. The neuroradiologists thread the catheter from your groin through the blood vessels up to the AVM and place it in a safe position close to the AVM before injecting the liquid glue. The glue hardens after it is injected into your AVM and blocks the flow of blood through the AVM.
What happens after embolisation?
You will need to keep your legs straight to prevent bleeding at the point where the catheter entered the blood vessel in your groin.
You will be observed closely by the medical team looking after you. Because there is a risk of stroke after embolisation, you should mention any unusual feelings if you develop them, although symptoms are likely to be short-lived. Many people experience a headache for a short while after the treatment. Normally, people go home within 48 hours of the procedure.
Some weeks or months after the embolisation, your doctors will want to repeat an angiogram to see how effective your treatment has been. If your AVM is large you might need to return for further embolisation treatment in stages over the following weeks or months.
If your AVM is not completely sealed, it still carries a risk of further bleeding. In this case, your doctors might decide to try one of the other possible treatments, if they are appropriate, in an attempt to get rid of the AVM.
Embolisation can be used to treat AVMs deep in your brain in areas that would be too difficult to reach during a craniotomy. However, it is less likely to seal off an AVM completely in just one go and you might need several separate sessions of treatment.
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Contents
- What are vascular malformations of the brain?
- Arteriovenous malformations (AVMs)
- Cavernous malformations (cavernomas)
- Developmental venous anomalies (venous malformations)
- Moyamoya disease
- Common questions about vascular malformations of the brain
- Symptoms of vascular malformations of the brain
- Tests and investigations for vascular malformations of the brain
- Possible treatments for vascular malformations of the brain
- Embolisation
- Stereotactic radiosurgery
- Neurosurgery (craniotomy)
- Other treatments for vascular malformations of the brain
- Everyday activities
- Research into vascular malformations of the brain
- Health professionals working with vascular malformations of the brain
- Useful contacts, support groups and further reading
- Thank you
- Your feedback on Vascular malformations of the brain
