Carl R. Darnall Army Medical Center - Health Library

Microvascular Occlusion

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

Definition

Microvascular occlusion uses a metal coil to fill the aneurysm. The metal coil prevents bleeding or a rupture. It may also fix a ruptured aneurysm.

This may also be called endovascular coil embolization.

Reasons for Procedure ^

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
GN00002_brain aneurysm.jpg

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).

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Possible Complications ^

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review possible problems such as:

  • Headaches
  • Weakness
  • Numbness or tingling
  • Speech problems
  • Vision changes
  • Confusion, memory loss
  • Infection
  • Adverse reaction to anesthesia
  • Kidney damage
  • Blood clots
  • Ruptured aneurysm

Your chances of problems are higher for:

What to Expect ^

Prior to Procedure

If there is no emergency, you may have:

Leading up to the procedure:

  • Talk to your doctor about the medicines you take. You may need to stop them up to 1 week in advance.
  • Don’t eat or drink after midnight the night before.
  • 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 pain. A sedative may be used to help you relax.

Description of the Procedure

A cut is made near the groin or upper thigh. A thin, hollow tube or sheath is inserted into the artery wall. A catheter is used to guide a wire. It goes through the artery to the brain. X-rays will direct the catheter to the aneurysm. A dye is placed to outline the aneurysm. A smaller catheter with a platinum coils are advanced to the spot. The coils fill and block the aneurysm.

The catheter is removed and the wound is closed.

Immediately After Procedure

You will need to lie still for at least 6-8 hours. Your blood pressure and other vital signs will be watched.

How Long Will It Take?

1-2 hours, maybe more

How Much Will It Hurt?

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

Average Hospital Stay

Normally, the length of stay is 1-2 days. You will need to stay longer if you have any problems.

Post-procedure Care

At the Hospital

During your stay, the healthcare staff will take steps to lower your chances of infection such as:

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

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

  • Washing your hands often and reminding your healthcare staff to do the same
  • Reminding your healthcare staff 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. To help with healing, you may need:

  • To rest between active times
  • To care for the wound to prevent infection
  • Physical or rehabilitative therapy

Call Your Doctor ^

Call your doctor if any of these occur:

  • Changes in balance, strength, or movement
  • Changes in mental state
  • Weakness, numbness, or tingling
  • Fever or chills
  • Redness, swelling, pain, bleeding, or pus from the wound
  • Headaches
  • Vision problems
  • Fainting
  • Pain that you cannot control with the medicines you were given
  • Nausea or vomiting
  • Bladder or bowel problems
  • Pain, swelling, or cramping in your legs

Call for emergency medical services right away for:

  • Seizures
  • Breathing problems
  • Chest pain

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

RESOURCES:

Brain Aneurysm Foundation
https://www.bafound.org

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

CANADIAN RESOURCES:

Brain Injury Canada
https://www.braininjurycanada.ca

Heart and Stroke Foundation
http://www.heartandstroke.ca

REFERENCES:

Cerebral aneurysm. American Association of Neurological Surgeons website. Available at: http://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Cerebral-Aneurysm. Accessed July 18, 2018.

Subarachnoid hemorrhage. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116453/Subarachnoid-hemorrhage. Updated June 6, 2018. Accessed July 18, 2018.

Treatment of brain aneurysm. The Aneurysm and AVM Foundation website. Available at: http://www.taafonline.org/conditions/aneurysm/treatment. Accessed July 18, 2018.

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

Last reviewed June 2018 by EBSCO Medical Review Board Michael Fucci, DO, FACC  Last Updated: 7/18/2018