Cerebral Embolization

Certain tumors of the brain and its coverings can bleed heavily during surgery. This can make the neurosurgeon's task very difficult and sometimes impossible. This difficulty can be eased by embolization (blocking) of the blood vessels feeding these tumors before surgery begins.

A cerebral tumor embolization is a procedure in which a catheter is placed into the patient's groin and carefully navigated into the blood vessels supplying the tumor under X‑ray guidance. An angiogram is obtained by injecting X-ray dye into the blood vessel to examine the blood supply of the tumor and verify that it is safe to eliminate that vessel. Material is then injected through the catheter to block the blood vessel under X-ray guidance. Occasionally, malignant tumors require embolization with stronger agents, such as alcohol or chemotherapy drugs.

• This procedure carries the risk of complications. You and your doctor should fully discuss the risks and the benefits of this procedure in advance.
  
• You will be contacted by a member of our team the day before your exam (between 4:30 and 6:30 pm) and given instructions on how you should prepare and what time you should arrive. If you are not contacted, please call 310‑423-4125 early on the morning of your procedure.
• Your doctor should fax all orders and lab results to 310‑423-0108 the day before your procedure.
• You should plan to arrive two hours before your scheduled procedure (three hours if you have not had all your pre‑op lab work done).
  
• You should not eat or drink anything from midnight before your procedure.
  
• You may take prescribed medication with a small sip of water on the morning of your procedure.
  
• You will not be allowed to drive after the procedure, so you should arrange for someone to help you get home.
  
• We want to make your waiting time as pleasant as possible. Consider bringing a magazine, book or music player to help you pass the time.
• Please leave your jewelry and valuables at home and wear comfortable clothing.

• You will check in at the South Tower information desk (across from the Emergency Department).
  
• A nurse will admit you to the observation care unit (OCU), where you will change into a hospital gown and will receive a brief clinical assessment by a nurse.
  
• Following admission, you will be transported to the Interventional Radiology Suite, where you will be greeted by the radiology nurse, technologist, interventional imaging physician and anesthesiologist.
  
• The physicians will explain the procedure to you including the risks and benefits associated with the procedure and answer any questions you may have.
  
• You will be asked to sign a form stating your informed consent for our team to perform your procedure.

• You will be placed flat on your back with your arms at your sides on the procedure table.
  
• Monitoring devices (a blood pressure cuff on your arm, an oxygen monitor on your finger and EKG leads on your chest) will monitor your blood pressure, breathing and heart during the procedure.
  
• An intravenous (IV) line will be placed in a vein in your arm to provide you with needed fluids and medication during your procedure.
  
• A catheter (a tiny tube) will be placed in your bladder to keep it empty during the procedure.
  
• Your groin area (the crease at the top of your leg) will be shaved, cleaned and covered with sterile drapes.
• At this point, you will be given general anesthesia which will make you sleep.
• The physician will numb your groin area by injecting a local anesthetic into the skin in your groin. You may experience a slight stinging sensation as the medication is injected.
  
• A catheter will be inserted and directed through your body to the site where the embolization will be performed.
  
• X‑rays will be taken during injection of an X-ray dye. You may feel a warm sensation from the dye that may last a few seconds.
  
• The injection of the dye may be repeated several times as the interventional physician maps the vessels of your brain.
  
• When the placement of the catheter has been confirmed, an embolization material will be injected through the catheter. This could be small flexible coils, small particles, a specialized foam or even a type of medical glue. You will not feel anything as the embolization material is injected.

• You will be transferred to the intensive care unit, where you will be observed during an overnight stay (approximately 23 hours).
  
• You will then be able to return home, but you will not be allowed to drive yourself.
  
• You will be ready to return to work in seven to 14 days.
  
• A member of our staff will keep in contact with you by telephone after you are discharged from the hospital.
  
• Depending on the reason for the embolization, it might take time before the results can be determined. In the case of excessive bleeding, it might take 24 hours to tell if the bleeding has stopped. In other cases it might take months to learn if the procedure worked. For example, if the procedure was to cut off blood to a tumor, it might take several months to determine if this was successful.
  
• You should discuss with your physician the results of the procedure and what follow‑up testing might be needed.