Embolization

Embolization is a minimally invasive, image-guided treatment that involves injecting a special material or a device into a blood vessel in order to block or close it. It can be used to:

• stop or prevent serious bleeding
• cut off the flow of blood to a tumor
• reduce blood flow to an arteriovenous malformation

When is embolization needed?

Embolization is used to treat certain conditions such as arteriovenous malformations, aneurysms, uncontrollable bleeding, and tumors.

How does embolization work?

Guided by x-ray pictures, the interventional radiologist threads a thin, hollow tube called a catheter into the abnormal artery or vein. He then uses a smaller catheter within the first catheter to inject a special material (an embolic agent) or a soft metal coil to clog or block the blood vessel.

What will happen before the procedure?

Someone from the hospital will call you a few days before the embolization to tell you where to go when you come to the hospital. The staff member will talk about when your child should stop eating, drinking, and taking medicines.

Your child may need to visit the pre-operative clinic, where she will meet with a nurse and an anesthesiologist, and undergo any necessary laboratory tests. You and your child will then meet with the nurse practitioner in the Interventional Radiology. Please plan on spending two to four hours at the hospital for the preoperative visit.

When you arrive at the hospital for the embolization procedure:

• The interventional radiologist will talk to you about the procedure and ask you to sign the consent form. (You must be your child's legal guardian to sign this form. If you are a legal guardian and not a parent, you must bring the paperwork showing proof of legal guardianship.)
• Your child will change into a hospital gown.
• A nurse or anesthesiologist may start an intravenous (IV) line.
• Once your child is asleep, you will be escorted to a special waiting area.

What happens during the procedure?

The radiology technologist will clean your child's groin with a special liquid that helps prevent infection. Through a tiny incision, the radiologist will insert a needle into the appropriate blood vessel in your child's groin. A long, thin tube (the catheter) is passed through the needle.

Under x-ray guidance, the catheter is guided to the appropriate blood vessel. The radiologist will then inject a special contrast solution through the catheter so that he can see the blood vessels more clearly.

Several x-rays may be taken to determine which vessels need embolization. The radiologist then places the embolization catheter in the correct location and injects the embolic agent or device. When the procedure is done, the catheter is removed and a bandage is placed on your child's skin.

What happens after the procedure?

Your child will be taken to the recovery room, where we will closely monitor him or her. You may be with your child in the recovery room. The interventional radiologist will speak with you after the procedure and explain the findings and results.

Is embolization safe?

Embolization is relatively safe, but it can be potentially associated with serious side effects. The interventional radiologist will explain these to you in detail before obtaining your permission to perform the procedure.

Your child will be exposed to ionizing radiation (x-rays) during this procedure. While we always attempt to minimize exposure to x-rays, we believe that the benefit of treatment outweighs the exposure that occurs during the exam. Because children are more sensitive to radiation exposure than adults, we have been leaders in adjusting equipment and procedures to deliver the lowest possible dose to young patients.

How Boston Children's Hospital approaches embolization

Embolization is performed by interventional and neurointerventional radiologists from the Boston Children's Hospital Department of Radiology who are highly trained in performing this procedure on infants and children.

In addition to the interventional radiologist, your child will be treated by a team of anesthesiologists, nurse practitioners, nurses, and technologists who specialize in caring for children who have undergone interventional radiology procedures and treatments.

We perform embolizations in the interventional radiology suite on the second floor of the hospital, which features three procedure rooms equipped with the latest imaging technology, a recovery area for patients who have received sedation or anesthesia, and examining rooms for outpatient visits.