Cerebral Coil Embolisation
Date issued: November 2024
For review: November 2026
Ref: B-305/RA/Imaging/Cerebral Coil Embolisation v3
PDF: Cerebral Coil Embolisation.pdf [pdf] 211KB
This leaflet tells you about having a cerebral coil embolisation. It explains what is involved and what the possible risks are. It is not meant to replace informed discussion between you and your doctor but can act as a starting point for such discussions. If you have any questions about the procedure, please ask the doctor who has referred you or the department which is going to perform it.
Referral and consent
The referring clinician should have discussed the reasons for this examination with you in the clinic and you should make sure that you understand these before attending. You will be referred to a Neurointerventional Radiologist for this procedure. Neurointerventional Radiologists are doctors who have trained and specialised in imaging and x-ray treatments.
Before the procedure you will need to sign a consent form, if one hasn’t previously been completed. This form says that you need to know what risks are involved. This is a legal requirement and ensures that you are fully informed about your procedure.
If after discussion with your hospital doctor or radiologist, you do not want this examination then you can decide against it. If the radiologist feels that your condition has changed or that your symptoms do not indicate such a procedure is necessary, then they will explain this to you and communicate with the referring clinician. You will return to your referring clinician for review.
At all times the radiologist and referring clinician will be acting in your best interests.
What is a cerebral coil embolisation?
Endovascular coiling is a procedure performed under general anaesthetic to block blood flow into an aneurysm.
An aneurysm is a weak area in a blood vessel that usually enlarges. It’s often described as a “ballooning” of the blood vessel.
Why do you need a cerebral coil embolisation?
Your aneurysm will have been diagnosed by previous examination e.g. CT scan, angiogram.
Aneurysms sometimes enlarge slowly and become weaker as they grow. If an aneurysm gets very large, it may produce pressure on the normal brain tissue or adjacent nerves. This pressure can cause difficulty with vision, numbness or weakness of an arm or leg, difficulty with memory or speech, or seizures. If left untreated they can occasionally rupture.
Are there any risks?
Cerebral coil embolisation is a major but normally safe procedure. There are a number of risks and complications that can arise. They are relatively rare; some are less than a major surgery, others are about the same.
There can be damage to the blood vessels through which the tubes are placed or damage to the aneurysm causing a leak. This may require other radiological procedures or further treatment in theatre.
There are small risks related to the anaesthetic which will be explained to you by your anaesthetist.
Are you required to make any special preparations?
If you have a morning appointment, you will be asked to have nothing to eat from midnight although you may still drink water up to 6am then sips of water for the 2 hours before your examination.
If you have an afternoon appointment you may eat normally up to 6am and then water only up to 10am with sips of water for the 2 hours before your examination.
If you have any allergies or have previously had a reaction to the dye (contrast agent), you must tell the radiology staff before you have the test. If you are taking warfarin, rivaroxaban, apixaban, ticagrelor (anticoagulants) this will be stopped before the procedure and you may require admission to hospital to give you an alternative.
If you are pregnant or suspect that you may be pregnant you should notify the department. A baby in the womb may be more sensitive to radiation than an adult. There is no problem with something like an x-ray of the hand or chest because the radiation field is at a safe distance from the foetus. However, special precautions are required for examinations where the womb is in, or near, the beam of radiation. If you are a female of childbearing age the radiographer will ask you if there is any chance of you being pregnant before the examination begins and you will be asked to sign a form. If there is a possibility of pregnancy, then your case will be discussed with the team looking after you to decide whether or not to recommend postponing the investigation.
There will be occasions when diagnosing and treating your illness is essential for your health and where the benefit clearly outweighs the small radiation risks. The procedure may go ahead after discussing all the options with you.
Who will you see?
A specially trained team led by a Neurointerventional Radiologist within the radiology department. Neurointerventional Radiologists have special expertise in reading the images and using imaging to guide catheters and wires to aid diagnosis and treatment.
Where will the procedure take place?
You will attend PIU / Postbridge / Erme ward prior to the procedure. You will be asked to get undressed and put on a hospital gown. A small cannula (thin tube) may be placed into a vein in your arm.
Our porters will collect you and bring you to the interventional radiology suite which is located within
X-ray East. This is similar to an operating theatre into which specialised X-ray equipment has been installed.
In the interventional radiology suite which is located within the radiology department. This is similar to an operating theatre into which specialised X-ray equipment has been installed.
What happens during an angiogram?
Before the angiogram, the Neurointerventional Radiologist will explain the procedure and ask you to sign a consent form. Please feel free to ask any questions that you may have and, remember that even at this stage, you can decide against going ahead with the procedure if you so wish.
You will be asked to lie on the X-ray table, generally flat on your back.
You will have whatever anaesthetic is best for you.
This procedure is performed under sterile conditions and the Neurointerventional Radiologist and radiology nurse will wear sterile gowns and gloves to carry out the procedure.
Whilst under anaesthetic, a urinary catheter may be placed in your bladder so that you are not distressed once the procedure is over.
Your skin near the point of insertion, usually the groin area, will be swabbed with antiseptic and you will be covered with sterile drapes. The skin and deeper tissues over the blood vessel will be numbed with local anaesthetic.
Using X-ray guidance, a needle followed by a wire and catheter (fine plastic tube) will be inserted into the artery and guided to the correct position inside the aneurysm.
Then the radiologist carefully places soft platinum micro-coils into the aneurysm and detaches them. The coils stay within the aneurysm and act as a mechanical barrier to blood flow, thus sealing it off. For an uncomplicated procedure, the hospital stay is usually one to two days. Recovery after the operation usually takes five to seven days. For a complicated surgery or endovascular treatment, or if an aneurysm has bled into the brain, hospitalization may last from one to four weeks, depending on the patient’s medical condition and any complications caused by the haemorrhage.
Once the Interventional Radiologist is satisfied with the images, the catheter will be removed. Firm pressure will be applied to the skin entry point, for about ten minutes, to prevent any bleeding. Sometimes a special device may be used to close the hole in the artery.
Will it hurt?
There may be a little discomfort related to the groin incisions for a few days afterwards. This usually settles quickly and can be controlled with painkillers.
How long will it take?
Every patient's situation is different, and it is not always easy to predict how complex or how straightforward the procedure will be, however, on average the anaesthetic and procedure will take two or three hours.
What happens afterwards?
You will be returned to a special unit to recover from the anaesthetic. You will normally go to a dependency unit for close observation for approximately 24 hours.
For an elective (booked) procedure you should be fit for discharge the following day.
Other Risks
A cerebral coil embolisation is a major but normally safe procedure but as with any procedure or operation complications are possible. We have included the most common risks and complications in this leaflet.
We are all exposed to natural background radiation every day of our lives. This comes from the sun, food we eat, and the ground. Each examination gives a dose on top of this natural background radiation.
Any exposure to ionising radiation (e.g. X-rays) has the potential to cause cancer later in life. This is much lower than the risk we all have of developing cancer in our life of ~1 in 3 and will be considered by the doctor before your procedure.
For information about the effects of X-rays read the publication: “X-rays how safe are they” on the Health Protection Agency
Finally
Some of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion about your treatment with the doctors looking after you. Make sure you are satisfied that you have received enough information about the procedure.
Contact
Interventional Radiology Department
01752 430838 - IR Co-ordinator
01752 432063 – Bookings Clerk
Additional Information
Bus services:
There are regular bus services to Derriford Hospital. Please contact:
Car parking:
Hospital car parking is available to all patients and visitors. Spaces are limited so please allow plenty of time to locate a car parking space. A charge is payable.
Park and Ride:
Buses (1/1A/42C/34) run from the George Junction Park and Ride Monday to Saturday (except Bank Holidays) every 15/20 mins from 6am. The last bus leaves the hospital at 11:30pm.
Plympton Park and Ride (52) runs from Coypool Park and Ride.
Parking is free although you will need to purchase a ticket to travel on the bus.
Patient Transport:
For patients unable to use private or public transport please contact The Patient Transport Service:
Devon GP: 0345 155 1009
Cornwall GP: 01872 25221
