Reasons for Procedure

Possible Complications

What to Expect

Call Your Doctor

En Español

Microvascular Occlusion

Pronounced: my-CROW-vas-q-lar oh-CLUE-shun

by Deanna M. Neff, MPH

Definition

Microvascular occlusion, also known as endovascular coil embolization, uses a metal coil to fill the aneurysm. This prevents bleeding and rupture. It may also be used if the aneurysm has already ruptured.

Reasons for Procedure TOP

Endovascular coil embolization prevents a brain aneurysm from causing more damage. It will not fix damaged areas of the brain, but it can improve quality of life by stopping bleeding.

Brain Aneurysm

An aneurysm is a weakened blood vessel in the brain that collects blood. The bulging, blood-filled pocket can put pressure on parts of the brain, pressing on nearby nerves. This can cause symptoms or cause the blood vessel to rupture (hemorrhage).

Possible Complications TOP

Problems may occur from the procedure. Your doctor will review potential problems, like:

Head ache
Weakness
Numbness or tingling
Speech disturbances
Visual changes
Confusion, memory loss
Infection
Adverse reaction to anesthesia
Kidney damage
Blood clots
Ruptured aneurysm during surgery

Factors that may increase the risk of complications include:

Discuss these risks with your doctor before the surgery.

What to Expect TOP

Prior to Procedure (Non-emergency Surgery)

Your appointment before the surgery may include:

Physical exam and blood tests
Imaging tests—ultrasound, CT scan, MRI scan, or angiogram
Discussion of allergies
Discussion of medications you are taking, including over-the-counter and herbal supplements
Discussion of recent illness or other conditions
Discussion of risks and benefits of treatment options

Before your procedure:

Arrange for a ride home.
Avoid food or drink after midnight the night before the procedure.
Discuss your medications with your doctor. You may be asked to stop taking certain medications before your procedure.

Women should let their doctor know if they are pregnant or planning to become pregnant.

Anesthesia

Local anesthesia is usually be used. It will block any pain. You may be given medications to relax you

Description of the Procedure TOP

You will be connected to monitors to watch your blood pressure, heart rate, and pulse during the procedure.

An IV will be placed in your arm for sedation and anesthesia.

An incision is made in the groin/inner thigh and a thin, hollow tube or sheath is inserted into the artery wall. A catheter is put in and guided by a wire through the artery and up towards the brain. Computer-aided X-rays will direct the catheter to the aneurysm and a dye is put in to define the aneurysm. A smaller catheter with a platinum coils are advanced to the aneurysm. The coils are used to fill and block the aneurysm.

The catheter is removed and the incision is closed.

Immediately After Procedure TOP

When the procedure is done, you will need to lie still for 6-8 hours or more. You will stay in the ICU, often for a day. Your blood pressure and other vitals will be monitored closely. You will be given medication for pain or other symptoms.

How Long Will It Take? TOP

1-2 hours or more

How Much Will It Hurt? TOP

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay TOP

This complex procedure is done in a hospital setting. The usual length of stay is 1-2 days. Your doctor may choose to keep you longer if complications arise.

Post-procedure Care TOP

At the Hospital

You will rest for several hours in the ICU.
Nurses will monitor your vital signs.

During your stay, the hospital staff will take steps to reduce your chance of infection, such as:

Washing their hands
Wearing gloves or masks
Keeping your incisions covered.

There are also steps you can take to reduce your chance of infection, such as:

Washing your hands often and reminding your healthcare providers to do the same
Reminding your healthcare providers to wear gloves or masks
Not allowing others to touch your incision

At Home

When you get home, you may have to adjust your activity level while you recover. This may take 3-6 weeks. Home care may include:

Resting when you need to
Caring for the wound
Physical or rehabilitative therapy

Call Your Doctor TOP

Contact your doctor if your recovery is not progressing as expected or you develop complications such as:

Any changes in physical ability, such as balance, strength, or movement
Any changes to mental status, such as consciousness, memory, or thinking
Weakness, numbness, tingling
Signs of infection including fever and chills
Redness, swelling, increasing pain, bleeding, or discharge from the incision site
Headache
Changes in vision
Fainting
Pain that cannot be controlled with the medications you've been given
Persistent nausea or vomiting
Trouble controlling your bladder and/or bowels
Pain, swelling, or cramping in your legs

Call for emergency medical services right away if any of the following occurs:

Seizure
Shortness of breath or chest pain
Loss of consciousness

If you think you have an emergency, call for medical help right away.

RESOURCES:

The Brain Aneurysm Foundation
http://www.bafound.org

National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov

CANADIAN RESOURCES:

Brain Injury Association of Canada
http://biac-aclc.ca

Heart and Stroke Foundation Canada
http://www.heartandstroke.com

References:

Cerebral aneurysm. American Association of Neurological Surgeons website. Available at:
...(Click grey area to select URL)
Updated March 2015. Accessed May 10, 2016.

Cowen J, Ziewacz J, Dimick J, et al. Use of endovascular coil embolization and surgical clip occlusion for cerebral artery aneurysms. J Neurosurg. 2007;107:530-535.

Subarachnoid hemorrhage.EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated December 31, 2015. Accessed May 10, 2016.

Treatment of brain aneurysms. The Aneurysm and AVM Foundation website. Available at:
...(Click grey area to select URL)
Accessed May 10, 2016.

Williams LN, Brown RD Jr. Management of unruptured aneurysms. Neurol Clin Pract. 2013;3(2):99-108.

Last reviewed June 2016 by Michael Woods, MD
Last Updated: 5/29/2014

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