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Doctors use endovascular coiling, also called endovascular embolization, to block blood flow into an aneurysm. An aneurysm is a weakened area in the wall of an artery. If an aneurysm ruptures, it can cause life-threatening bleeding and brain damage. Preventing blood flow into an aneurysm helps to keep it from rupturing.
For endovascular coiling, doctors use a catheter, a long, thin tube inserted into a groin artery. The catheter is advanced into the affected brain artery where the coil is deployed. X-rays help guide the catheter into the artery. The coils are made of soft platinum metal, and are shaped like a spring. These coils are very small and thin, ranging in size from about twice the width of a human hair to less than one hair's width.
Doctor’s also use coiling to treat a condition called arteriovenous malformation, or AVM. An AVM is an abnormal connection between an artery and a vein. It may occur in the brain, spinal cord, or elsewhere in the body.
Doctors most commonly use coiling to treat a cerebral aneurysm at risk for rupturing. In some cases, they may use it to repair a ruptured aneurysm.
There may be other reasons for your doctor to recommend a coiling procedure.
If you are pregnant or think you may be pregnant, you should tell your healthcare provider.
There is a risk for allergic reaction to the dye injected to allow the aneurysm to be viewed on X-ray. People who are allergic to or sensitive to medications, contrast dye, or iodine should tell the radiologist or technologist. People with kidney failure or other kidney problems should tell the radiologist.
People who take anticoagulant (blood-thinning) medications, such as aspirin, coumadin (Warfarin), clopidogrel (Plavix), or others, should tell their doctor prior to the procedure. These medications may be stopped for one or more days prior to the procedure.
Because the procedure involves the blood vessels and blood flow of the brain, there is a risk for complications involving the brain. These complications may include:
There may be other risks depending on your specific medical condition. Discuss any concerns with your doctor prior to the procedure.
You will need to stay in the hospital for a coiling procedure. Procedures may vary depending on your condition and your doctor's practices.
Your procedure may be done by one or both of these specialists:
During the procedure, you are asleep under general anesthesia. In some situations, it may be done under local anesthesia.
Generally, a coiling procedure follows this process:
After the procedure, you may be taken to the recovery room or the intensive care unit (ICU) for observation. If the coiling procedure was done for a ruptured aneurysm, you will most likely be taken to the ICU for recovery and observation. If the coiling procedure was done for an unruptured aneurysm and your condition is otherwise stable, you may be able to go home a day or two after the procedure.
You will remain flat in bed for as long as 12 to 24 hours after the procedure. A nurse will monitor your vital signs, neurological signs, the insertion site, and circulation or sensation in the affected leg or arm.
You may be given pain medication for pain or discomfort from the procedure or from having to lie flat and still for a prolonged period.
You may resume your usual diet after the procedure, unless your doctor decides otherwise.
Once you have recovered, you may be able to go home, unless your doctor decides otherwise. In some cases after a procedure for a ruptured aneurysm, a transfer to a rehabilitation facility may be necessary to help continue recovery from damage that may have occurred as a result of the ruptured aneurysm.
You may be advised not to do any strenuous activities. Your doctor will instruct you about when you can return to work and resume normal activities. Tell your doctor to report any of the following:
Generally, a cerebral angiogram will be done periodically after the procedure make sure the coiling is working. The first angiogram may be done about one month after the procedure. Additional cerebral angiograms and/or other imaging procedures, such as MRI or MRA may be done at intervals to be determined by your doctor based on your condition and the results of previous post-coiling imaging procedures.
Your healthcare provider may give you other specific instructions about what you should do after an endovascular coiling.
Before you agree to the test or the procedure make sure you know:
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