Advice after your nerve block for surgery
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Introduction
We have been advised by your hospital consultant that you need to have an embolisation procedure. Embolisation is a procedure where a vessel (normally an artery) is deliberately blocked using small particles, coils (small metal wires) or glue.
Some potential indications for a vascular embolization include:
- you are having an operation for a tumour with a rich blood supply and embolisation may help to reduce blood loss during the operation
- You have a tumour which may reduce in size or symptoms by stopping the blood supply to it
- you have non-cancerous tumour which is at risk of spontaneous bleeding
- you have been bleeding, either from a traumatic injury, vascular malformation or tumour
These are done in the radiology department by an Interventional Radiologist (doctor
specialising in medical imaging), by guiding a small plastic tube (catheter) into the body under ultrasound and fluoroscopic guidance to access a vessel. This allows us to guide wires and the small embolisation particles into the correct location. The procedure will be performed by a radiologist who will be assisted by radiographers and radiology nurses.
This information tells you about having the procedure, what is involved, and what the possible risks are. This is not intended to replace the discussion between you and your consultant, but may act as a starting point for discussion. If after reading this information you still have concerns or require further explanation, please contact us using the telephone number on your appointment letter or ask the ward staff.
What is Fluoroscopy?
Fluoroscopy is a process that uses X-rays to produce a real time moving image on a
television monitor.
Before your appointment
Please let us know if:
- you are taking any medication which impair the bloods ability to clot (anticoagulation or blood thinning drugs) e.g. Warfarin or clopidigrel, or, if you are aware that you may have bleeding problems. The radiologist who will be performing your examination can be notified and may need to discuss this with you and your hospital consultant before your appointment can be confirmed as the medication may need to be stopped or changed before the procedure. The Interventional nursing team can be informed on 0300 613 2161 (Frimley) or 0300 615 3544 (Wexham).
Please also let us know if:
- there is any chance of you being pregnant
- you have limited mobility and will require assistance to get on and off the scanner.
- you will need an interpreter. We are not able to use family members or friends to interpret.
- there is any possibility that you may be pregnant.
- you are diabetic - please note that you are required to starve before the examination. You may be given an early morning appointment or alternative medication will be given on the ward.
In order to make your appointment run more smoothly, please let us know if any of these apply, in advance, by calling our bookings team (contact details are displayed on the main Radiology page).
Please review the contrast safety questionnaire enclosed in this letter and fill this in before your appointment. This can be completed on paper and where indicated this can also be completed online.
Eating and Drinking
You should have nothing to eat 6 hours prior to the time of your procedure. You can continue to drink clear fluids (water) up to 2 hours prior to the procedure but then nothing should be consumed.
| 6 hours prior the procedure |
2 hours prior the procedure |
|
| Light food | No Food | No food |
| Any drink | Clear Fluids | No fluids |
What to bring with you
You will usually be admitted for the procedure as a day case. Depending on what body part we are treating it may be necessary for patients to stay overnight in hospital after the embolisation. For this reason, we advise that you prepare an overnight bag and bring this with you. You may wish to bring your own dressing gown, slippers and reading material.
Please bring with you to your appointment any sprays or inhalers that you are taking. Please bring a list of any regular medications you are taking
During the procedure
Referral and consent
You will be asked to sign a consent form confirming that you understand the procedure and are aware of the risks and benefits involved. Where practical this is usually done on the ward, before you come to the Radiology Department or in an outpatient clinic environment before your admission to hospital for the procedure.
The procedures are normally done as a planned procedure and you should have plenty of time to discuss the situation with your doctor or the nurse specialist looking after you before you sign the consent form. When you arrive for the procedure you will also discuss the procedure with the radiologist who will be performing the procedure who will again sign the consent form with you.
If after discussion with your hospital doctor or radiologist, you do not want the procedure carried out, 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 they will communicate with the referring doctor who will review your situation as soon as possible. At all times the radiologist and referring doctor will be acting in your best interests.
Procedure
You will need to wear a hospital gown. The Porters will collect you from the ward and bring you to the X-ray Department, on your bed, for the procedure.
The procedure will be explained to you by the radiologist. You will be able to ask any further questions that you may have.
You will be asked to lie on the examination table. It is important that you stay very still until the procedure is over. If you are uncomfortable please let the doctor know. You will need a cannula (small tube) inserted into a vein in your arm to allow access for fluids and for administering medication.
The radiologist will keep everything as sterile as possible, and will wear a theatre gown and operating gloves. The skin near the point of insertion, usually the groin, will be thoroughly cleaned with antiseptic, and then most of the rest of your body covered with a theatre towel.
The skin and deeper tissues over the artery in the groin will be anaesthetised with local anaesthetic, and then a needle will be inserted into this artery. Once the radiologist is satisfied that this is correctly positioned, a guide wire is placed through the needle, and into the artery. Then the needle is withdrawn allowing a fine, plastic tube (a catheter) to be placed over the wire and into this artery.
The radiologist will use X-ray fluoroscopy to make sure that the catheter and the wire are then moved into the arteries. A special x-ray dye, called contrast medium, is injected down the catheter into the arteries, and this may give you a warm feeling.
Once the blood supply has been identified the metal coils, glue or particles are delivered into the vessel through the catheter to block the blood flow. This may need to be repeated in different locations.
At the end of the procedure, the catheter is withdrawn and the radiologist then presses on the artery in the groin to stop any bleeding.
After the procedure
Once you have returned to your ward, nurses will carry out close and regular observations, such as taking your pulse, blood pressure and temperature, to make sure that there are no problems. You may be required to stay in bed for at least four hours. You should tell the nurses if you feel worsening pain or a rise in your body temperature. You should drink plenty of fluids and eat normally
If you have any problems after the procedure please speak to the staff on the ward or contact your GP or emergency doctor if problems occur when you have returned home
Will it hurt?
When the local anaesthetic is injected, it will sting initially, but this soon passes, and the area should then feel numb with only the sensation of pushing remaining. Occasionally anaesthetic support will be required for the case meaning you will not have full sensation of pain however this is not required or recommended for most cases.
How long does it take?
The duration of the case varies heavily depending on the body part which we are embolising.
As an approximate guide, expect to be in the Radiology Department for about an hour and a half to two and a half hours, although you may be with us for longer. Some of this time is taken up by preparation rather than the procedure itself, particularly if your case requires anaesthetic support. You will normally be expected to rest on the ward for at least four hours after the procedure and may need to remain in hospital overnight.
Risks
As with any procedure or operation, complications are possible. The possibility of these occurring will vary for each patient and the possibility of these happening to you will be discussed with you, before you sign the consent form.
- Bleeding: Any intervention on a blood vessel carries a risk of bleeding. There may be a small bruise around the site where the needle has been inserted and this is quite normal. There is a chance that the bruise may become very large and uncomfortable, but this does not happen very often.
- X-rays used in the procedure are a type of radiation. We are all exposed to natural background radiation every day from the sun, food we eat, and the ground. Exposure to medical X-rays carries a small additional risk, but your doctor feels that this risk is outweighed by the benefits of having the procedure and the amount of radiation you will receive is kept to as low as reasonably possible.
Contact us
If you have any queries relating to this information, please contact the Radiology service.
About this information
Service:
Radiology
Reference:
PILS-IR.11
Approval date:
2 October 2024
Review date:
2 October 2027
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.