• Information
• Publications
  • Brain and Spine Booklets
  • About our publications
  • Get involved publications
  • Case studies
• Children's resources
• Neurological centres
• Glossary
• Information Access toolkit
• Communication skills project

|

Embolisation is one of the more recent treatments for AVMs. A highly trained neuroradiologist, who has considerable experience with the technique, should perform it. Embolisation involves injecting liquid glue or coils into an AVM of the brain or the dura, using a long catheter similar to the one used for an angiogram. In most circumstances, embolisation is used to shrink an AVM so that it is suitable for radiosurgery or neurosurgery. The technique can also reduce the risk of bleeding during subsequent neurosurgery. Occasionally, embolisation can block off the blood supply to an AVM and get rid of it completely. Embolisation usually succeeds in at least reducing the size of the AVM, and can sometimes reduce symptoms such as noises in the head, or headaches.

What happens before embolisation?
Unless embolisation is performed as an emergency, you will be admitted to hospital the night beforehand, 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. On the day of the procedure, you will be taken to the Radiology
department. One or both of your groins will be shaved, and you will be given a local anaesthetic before threading a catheter up a blood vessel to the AVM. Occasionally light sedation (a calming drug) or a general anaesthetic is used, if you find the procedure hard to cope with.

What happens during the embolisation?
The procedure takes a variable period of time, usually a matter of hours, according to the complexity of the tangle of vessels. Before injecting any glue, the radiologist may inject a small amount of a drug into the vessels supplying your AVM to test the function of the area of your brain supplied by these vessels. The glue hardens rapidly as it is injected into your AVM. This blocks off the blood flow through the
AVM.

What will happen after embolisation?
You will need to keep your legs straight to allow a blood clot to form at the point where the catheter punctured the blood vessel in your groin. You will be observed closely after the embolisation. Because there is a small risk of stroke afterwards, you should mention any unusual symptoms if you develop them, although they are likely to be only short-lived. Many people experience a headache for a little while after the treatment. Normally, people go home within 24 to 48 hours of the procedure.

Some weeks or months after the embolisation, your doctors may want to repeat an angiogram or MRI scan to see how effective the treatment has been. If your AVM is large you may need to return for further embolisation treatments, in stages over weeks or months. If your AVM is not completely sealed off, it probably carries a risk of further bleeding. In this case, your doctors may decide to try one of the other treatments, if they are appropriate, in an attempt to get rid of the AVM.

Like radiosurgery, embolisation does not involve you having a craniotomy, and it can be used to treat malformations in deep areas of your brain. However, it is less likely to totally seal off AVMs; it may require several separate sessions of treatment, and involves the use of new materials, some of which are still under investigation.