Embolization

Embolization is a minimally invasive procedure that blocks blood flow through specific arteries or veins. It’s a type of interventional radiology, which uses catheters (thin, flexible tubes) and imaging guidance to treat diseases without major surgery. We may use embolization to treat abnormal blood vessels, internal bleeding, tumors, and other conditions.

Embolization works by using embolic agents to stop blood from flowing through blood vessels. An interventional radiologist delivers the embolic agent using a catheter. We make a small needle puncture or incision (cut) in your skin and insert the catheter into a blood vessel. X-ray technology, called fluoroscopy, helps us guide the catheter to the correct blood vessel and deliver the embolic agent. The interventional radiologist views the procedure on a video monitor.

Embolic agents may include:

• Devices: Coils, balloons, and plugs stop blood flow in large arteries.
• Gelatin foam: Pieces of sponge-like material temporarily plug a blood vessel and then dissolve.
• Glue: Liquid glue stops excessive bleeding and helps prevent bleeding during surgery. 
• Sclerosing agents: Chemical substances such as alcohol permanently shrink or destroy blood vessels.

At Penn Medicine, our interventional radiologists have experience in all types of embolization. In fact, we’re often the first in the region to introduce new techniques, giving our patients more options for nonsurgical treatment.

Some types of embolization we offer include:

• Chemoembolization: uses chemotherapy drugs and an embolic agent to cut off the blood supply to tumors
• Pulmonary arteriovenous malformation (PAVM) embolization: closes off an abnormal connection between arteries and veins in the lungs
• Prostate artery embolization: reduces blood flow to an enlarged prostate and eases urinary symptoms
• Uterine fibroid embolization: cuts off the blood supply to fibroids (growths in the uterus), causing them to shrink
• Varicocele embolization: uses devices to treat enlarged blood vessels, or varicose veins, in the scrotum

We may recommend embolization for:

• Aneurysms
• Arteriovenous malformations in the brain and spinal cord
• Certain types of cancer or benign (noncancerous) tumors
• Gastrointestinal bleeding
• Heavy menstrual bleeding due to uterine fibroids
• Internal bleeding due to traumatic injuries

Before embolization, you may need blood tests or imaging exams such as an ultrasound, MRI, or CT scan. Before the procedure, your health care provider may ask you to stop taking certain medications such as aspirin or blood thinners. You might need to stop eating or drinking the night before your embolization.

Some types of embolization are outpatient procedures, so you go home the same day. Others require overnight hospitalization. Embolization might take place in an operating room or an interventional radiology and catheterization lab. The total procedure time can take from 30 minutes to several hours.

During embolization, here’s what you can expect:

1. A nurse gives you a sedative or general anesthesia through a vein in your arm, so you don’t feel any pain during the procedure.
2. We connect you to monitors to check your blood pressure, pulse, oxygen level, and heart rate during the procedure.
3. The interventional radiologist makes a cut or needle puncture in your groin, wrist, or neck.  
4. We use imaging guidance to insert a catheter into the blood vessel and inject a contrast material into your bloodstream.
5. The interventional radiologist locates the area that needs treatment and delivers the embolic agent.
6. We make sure blood flow in the blood vessel has stopped before removing the catheter and closing the incision.

Embolization is a minimally invasive procedure, so it doesn’t require a lengthy recovery. Recovery can take from a few days to two weeks. You may have pain, soreness, and bruising in the area where we inserted the catheter. Other potential side effects can include fever, nausea, vomiting, headache, or abdominal pain. Some people have a mild allergic reaction to the contrast material.

Embolization is a relatively safe procedure, but it does carry some risks that include:

• Blood clots
• Infection
• Misplaced or migrated embolic agent, which can result in stroke or other serious health complications
• Necrosis (death of body tissue)
• Nerve damage

At Penn Medicine, you have convenient access to leading-edge technology and experts who are leaders in their fields. We are home to one of the largest interventional radiology programs in the country and routinely treat the most complex diseases using minimally invasive techniques.

When you turn to us for care, you’ll find:

• Experienced team: Our board-certified interventional radiologists, radiology technologists, and registered nurses perform a large volume of interventional procedures each year. This depth of experience means better outcomes for our patients.
• Less pain, faster recovery: Our capabilities in minimally invasive techniques such as embolization mean you can get the treatment you need with fewer risks and less downtime. You can focus more on healing and doing the activities you love.
• Multispecialty approach: Interventional radiologists collaborate with cardiologists, heart and vascular surgeons, oncologists, gastroenterologists, neurosurgeons, and other specialists to deliver the care you need, all from one source.