How is embolisation of an artery done?
First an angiogram is done by injecting the main artery with iodinated contrast to visualise the origin of the target vessel from the main vessel. The arteries can be approached either through the groin or wrist by introducing small tubes known as catheters under local anaesthesia. Once the origin and distribution of the target vessel to be embolised is found out by angiography, a guide catheter is introduced and parked in the target branch. If the target vessel is quite small, a micro catheter can be introduced through the guide catheter and tip localised at the region of interest. Once it is in position, either gel foam or coils can be delivered to produce embolisation and vessel closure. If liquid material is being introduced, as in case of alcohol septal embolisation in hypertrophic cardiomypothy, it is necessary to occlude the parent artery (left anterior descending coronary artery in this case) prior to delivery of the agent to prevent it from spilling over to the parent artery and causing extensive damage. Bronchial arteries are embolised to prevent severe and recurrent hemoptyis (spitting of blood). Sometimes the uterine artery is embolised to prevent recurrent and severe uterine bleeding. Major aortopulmonary collateral arteries can be embolised along with surgical correction of Tetralogy of Fallot.