Embolisation procedure overview

Overview

Embolisation is a medical procedure that blocks blood flow to a specific area of the body. A doctor called an interventional radiologist uses a thin, flexible tube called a catheter to deliver tiny particles or coils into blood vessels. This stops blood from reaching a tumour, a bleeding spot, or an abnormal cluster of vessels. The aim is to treat the problem without major surgery.

Embolisation is not done every day, but it is a well-established procedure available at many hospitals, especially those with a specialist radiology department.

The people who may be helped by embolisation vary because it is used for different conditions. For example, women with heavy bleeding from fibroids, people with bleeding after an injury, and patients with certain liver or kidney tumours may all be considered for this treatment.

Symptoms

Common symptoms

• Heavy or prolonged menstrual bleeding that does not improve with other treatments
• Pain or pressure in the pelvis from uterine fibroids
• Sudden, severe bleeding from an injury or a medical condition
• Headaches or risk of bleeding from a brain aneurysm or arteriovenous malformation (AVM)

Symptoms in children

• In children, embolisation may be used for certain types of vascular malformations (abnormal blood vessel tangles) that can cause pain, swelling, or skin changes.
• It is sometimes used to treat bleeding tumours, such as some types of liver tumours in children.

Symptoms in older adults

• Older adults might need embolisation for bleeding due to an aneurysm or for tumours that are hard to remove with surgery.
• It may also be used to control bleeding from the stomach or bowel when other measures are not possible.

Causes

Main causes

• Uterine fibroids (noncancerous growths in the uterus) that cause heavy bleeding or pain
• Tumours in the liver, kidney, or other organs that need to be shrunk or have their blood supply cut off
• Arteriovenous malformations (AVMs) – tangles of blood vessels that can bleed or cause other problems
• Active bleeding from an injury, after childbirth, or from a blood vessel that has burst

Risk factors

• Having a condition that makes bleeding more likely, such as a bleeding disorder or taking blood-thinning medicines
• Having liver disease that can cause abnormal blood vessels in the liver
• Being older, as blood vessels can become weaker over time
• Having a family history of aneurysms or vascular malformations

When to see a doctor

See a doctor urgently if:

• If you have sudden, heavy bleeding that does not stop with simple first aid, seek emergency care.
• If you have a severe headache with stiff neck, vision changes, or confusion, go to the emergency room.

Book a routine appointment if:

• If you have persistent heavy periods that affect your daily life, talk to your GP or a gynaecologist.
• If you have been told you have a tumour or a vascular malformation and want to discuss treatment options, ask for a referral to an interventional radiologist.
• If you have ongoing pain or swelling that you think might be related to a blood vessel problem.

Diagnosis

Before embolisation, doctors need to find the exact cause of your symptoms. They will use imaging tests to look at your blood vessels and the area that may need treatment.

Tests that may be done

• Ultrasound – often used for fibroids or to see blood flow in organs
• CT scan (computed tomography) – detailed pictures of the inside of your body
• MRI (magnetic resonance imaging) – gives very clear images of soft tissues
• Angiography – a special X-ray where dye is injected into your blood vessels to see them clearly

What to expect at your appointment

You will usually have a consultation with an interventional radiologist. They will review your medical history, do a physical exam, and suggest the best imaging tests. The tests are generally painless but may involve lying still for a while. Afterwards, your doctor will explain if embolisation is a good option for you.

Treatment

Embolisation is one of several treatment options. It is not the only choice, and your doctor will discuss alternatives such as medicines (for example, to control bleeding), other minimally invasive procedures, or surgery. The procedure itself is done by a specialist radiologist, often under local anaesthetic with sedation, so you are awake but relaxed. A tiny cut is made in your groin, arm, or wrist, and a catheter is guided through your blood vessels to the target area using X-ray video. Then tiny particles, coils, or a special glue is released to block the vessel. The whole process can take one to three hours, depending on the complexity.

Self-care at home

• Before the procedure, follow your hospital’s instructions about eating and drinking – you may need to fast for several hours.
• After the procedure, rest for the rest of the day and avoid heavy lifting or strenuous activity for a few days.
• Keep the puncture site clean and dry. You may have a small bruise, which is normal.
• Drink plenty of water to stay hydrated and help your body recover.
• Take pain relief as advised by your healthcare team – usually over-the-counter medicines are enough, but always check with your doctor.

Medical treatments

Embolisation is a medical procedure itself. Other treatments for the underlying condition may include hormone therapies to shrink fibroids, medicines to control high blood pressure or bleeding risk, and other interventional procedures like radiofrequency ablation (using heat to destroy tissue). Surgery, such as myomectomy (removal of fibroids) or hysterectomy, is sometimes used if embolisation is not suitable or does not work. Your doctor will recommend the approach that best fits your health and preferences.

When is surgery considered?

Surgery may be considered if embolisation is not possible, for example if the blood vessels are too small or if the condition is better treated by removing the affected organ. Your doctor will explain when surgery might be the better option.

Living with this condition

After embolisation, most people go home the same day or stay in hospital overnight. You may feel tired or have some mild pain for a few days. Most people return to normal activities within a week. You will have a follow-up appointment to check how well the treatment worked, often with an imaging test after a few months.

Lifestyle tips

• Stay active but avoid heavy lifting or vigorous exercise for about a week after the procedure.
• Watch for signs of infection at the puncture site – redness, swelling, warmth, or fever – and contact your doctor if these occur.
• If you are taking blood-thinning medicines (anticoagulants), ask your doctor when it is safe to restart them.
• Keep all follow-up appointments so your doctor can monitor your progress.

Diet and exercise

There are no special dietary restrictions after embolisation. A balanced diet with plenty of fruits, vegetables, and whole grains supports healing. Gentle walking is fine the day after the procedure, but avoid heavy exercise for about a week. Your doctor will give you personalised advice.

Mental health and emotional wellbeing

Waiting for a procedure and recovering from it can be stressful. Some people feel anxious about the outcome or worry about possible complications. It is normal to have these feelings. Talk to your healthcare team – they can answer your questions and reassure you. If you feel very anxious or down, reach out to a counsellor or a support group for people with similar conditions.

Prevention

Embolisation is usually a treatment, not a preventive measure. Most of the conditions it treats, such as fibroids or vascular malformations, cannot be prevented. However, a healthy lifestyle that includes not smoking, managing blood pressure, and maintaining a healthy weight may lower your risk of some blood vessel problems.

Screening programmes

There is no routine screening for conditions that might require embolisation. If you have symptoms such as heavy bleeding, pelvic pain, or unexplained bleeding, see your doctor for evaluation.

Complications

If left untreated

• If a condition like a bleeding fibroid or an aneurysm is left untreated, it can lead to severe, life-threatening bleeding.
• Untreated uterine fibroids may cause ongoing heavy periods, anaemia (low blood count), and pain.
• A vascular malformation that is not treated could enlarge and cause pain, skin ulcers, or bleeding.

Long-term outlook

Embolisation is usually very effective. Most people who have the procedure experience significant improvement in their symptoms. For example, women with fibroids often see a 50-80% reduction in heavy bleeding and pain. Like any medical procedure, there are some risks, such as a small chance of infection, bruising at the puncture site, or the embolic material going to the wrong place. Your doctor will explain these risks before the procedure. Overall, the outlook is positive, and complications are uncommon when performed by an experienced radiologist.

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