Cerebral angiography with embolization
What is Cerebral Angiography with Embolization?
Cerebral angiography with embolization is a minimally invasive procedure used to diagnose and treat vascular abnormalities in the brain, such as aneurysms, arteriovenous malformations (AVMs), or fistulas, by injecting embolic agents to block abnormal blood flow. Cerebral angiography visualizes brain blood vessels, while embolization therapeutically occludes targeted vessels to prevent rupture, bleeding, or other complications. In India, this procedure is performed in interventional neuroradiology or neurosurgery departments at hospitals like Apollo, Fortis, Medanta, and AIIMS, offering advanced care at affordable costs. Understanding the procedure, costs, recovery, risks, and frequently asked questions (FAQs) is crucial for patients and families in India to make informed decisions.
Why do you need Cerebral Angiography with Embolization?
This procedure is indicated for:
- Cerebral aneurysms: To prevent rupture or treat ruptured aneurysms as an alternative to clipping/coiling.
- Arteriovenous malformations (AVMs): Abnormal connections between arteries and veins, risking hemorrhage.
- Dural arteriovenous fistulas (dAVFs): Abnormal connections often causing pulsatile tinnitus or hemorrhage risk.
- Tumor embolization: Pre-surgical embolization of highly vascular tumors (e.g., meningiomas) to reduce intraoperative bleeding.
- Acute ischemic stroke: Rarely, to embolize a bleeding source post-thrombolysis.
- Carotid-cavernous fistulas (CCFs): To treat symptoms like vision loss or proptosis (bulging eye).
The procedure aims to occlude abnormal vessels, reduce hemorrhage risk, or prepare for surgery while preserving normal brain vasculature.
Why Do Cerebral Angiography with Embolization Costs Vary in India?
Costs range from ₹1.5 lakh to ₹5 lakh :
- Procedure Complexity: Simple embolization (₹1.5–3 lakh); complex cases (e.g., large AVMs, ₹3–5 lakh).
- Hospital/Location: Higher in metro cities (Apollo, Fortis); lower in government hospitals (AIIMS, ₹50,000–₹1.5 lakh).
- Surgeon’s Expertise: Experienced interventional neuroradiologists charge more.
- Additional Costs: Embolic agents (e.g., Onyx, coils: ₹50,000–₹2 lakh), hospital stay, imaging (MRI/CT), ICU (if needed).
- Insurance: Covered for symptomatic or high-risk conditions; Ayushman Bharat offers subsidies.
Cerebral Angiography with Embolization Procedure
- Before Procedure Evaluation:
- Diagnosis:
- Imaging: CT angiography (CTA), MRI, or magnetic resonance angiography (MRA) identifies the vascular abnormality.
- Symptoms: Vary by condition (e.g., severe headache for aneurysm rupture, pulsatile tinnitus for dAVF, seizures for AVM).
- Blood tests: Assess kidney function (for contrast dye), coagulation (e.g., INR), and overall health.
- Medications: Blood thinners (e.g., aspirin) may be stopped 5–7 days prior; antihypertensive drugs control blood pressure.
- Consent: Risks, including stroke or vessel perforation, are explained.
- Diagnosis:
- Procedure:
- Cerebral Angiography:
- Performed under local anesthesia with sedation (or general anesthesia for uncooperative patients), lasting 1–3 hours.
- A catheter is inserted via the femoral artery (groin) or radial artery (wrist) and guided to the brain’s arteries using fluoroscopy (real-time X-ray).
- Contrast dye is injected to visualize the vessels, creating a detailed map (angiogram) of the abnormality.
- Embolization:
- Once the target (e.g., aneurysm, AVM feeding artery) is identified, embolic agents are delivered through a microcatheter:
- Liquid agents: Onyx, NBCA (glue) for AVMs or fistulas.
- Coils: Platinum coils for aneurysms (similar to coiling).
- Particles: PVA particles for tumor embolization.
- The agent blocks blood flow to the abnormality while preserving normal vessels.
- Post-embolization angiogram confirms occlusion and checks for complications.
- Once the target (e.g., aneurysm, AVM feeding artery) is identified, embolic agents are delivered through a microcatheter:
- The catheter is removed, and the groin/wrist site is closed (manual pressure or closure device).
- Cerebral Angiography:
- After Procedure:
- Monitoring: 6–12 hours of bed rest with leg immobilization (femoral access) to prevent groin hematoma.
- Hospital stay: 1–3 days (unruptured cases); 1–2 weeks (ruptured cases or complications).
- Pain: Mild groin discomfort, managed with analgesics (e.g., paracetamol).
- Hydration: IV fluids flush out contrast dye to protect kidneys.
- Neurological checks: For signs of stroke or bleeding (e.g., weakness, speech difficulty).
Recovery After Cerebral Angiography with Embolization
- Hospital Stay: 1–3 days (unruptured); 1–2 weeks (ruptured or complications).
- Post-Procedure Care:
- Pain: Groin soreness for 2–3 days, managed with analgesics.
- Activity: Bed rest for 6–12 hours post-procedure; avoid heavy lifting for 1–2 weeks.
- Neurological monitoring: For deficits (e.g., weakness, vision changes), which may indicate stroke.
- Blood thinners (e.g., aspirin) may be prescribed for 1–3 months to prevent clotting.
- Diet: Normal diet; 2–3 liters water daily to flush contrast dye.
- Follow-Up:
- Visit at 1–2 weeks to check the access site and neurological status.
- Imaging (e.g., angiogram, MRI) at 3–6 months to confirm occlusion and monitor for recurrence.
Most resume normal activities in 1–2 weeks (unruptured) or 4–6 weeks (ruptured). Success rates are 85–95% for complete occlusion (aneurysms/AVMs), though AVMs may require multiple sessions or adjunctive surgery/radiosurgery.
Risks and Complications
- Procedure Risks:
- Stroke (2–5%): Due to clot formation or vessel occlusion.
- Vessel perforation (1–3%): Risking hemorrhage.
- Groin hematoma (2–5%): From femoral access site.
- Post-Procedure Complications:
- Rebleeding (1–3%): If occlusion is incomplete.
- Neurological deficits (3–5%): Weakness, speech/vision issues.
- Contrast-related: Kidney injury (<1%, higher in diabetics), allergic reaction (rare).
- General Risks: Infection (access site, <1%), seizures (1–2%, esp. with AVMs).
- Long-Term: Recurrence (5–15%, esp. AVMs), need for retreatment, radiation exposure (from fluoroscopy).
Report severe headache, weakness, or swelling at the access site promptly.
Frequently Asked Questions (FAQs)
What causes these vascular abnormalities?
Aneurysms: Hypertension, smoking, genetics. AVMs/dAVFs: Often congenital or post-trauma.
Can embolization cure the condition?
Aneurysms: Often curative (85–95% success). AVMs: May reduce size/risk but often requires additional treatments (surgery, radiosurgery).
Is the procedure painful?
Minimal discomfort (groin site); sedation ensures comfort during the procedure.
How soon can I resume activities?
1–2 weeks (unruptured), 4–6 weeks (ruptured).
Is this procedure covered by insurance in India?
Yes, for symptomatic or high-risk conditions; confirm with your provider.
Signs of complications?
Severe headache, weakness, vision changes, or swelling at the groin.
Can the abnormality recur?
Yes, 5–15% risk, higher with AVMs; regular imaging follow-up is needed.
Lifestyle changes post-procedure?
Manage blood pressure, quit smoking, avoid heavy lifting for 1–2 weeks, and attend follow-ups.
Conclusion
Cerebral angiography with embolization is an effective, minimally invasive treatment for brain vascular abnormalities, with high success rates for reducing hemorrhage risk. India’s top hospitals (Apollo, Fortis, AIIMS) offer affordable, expert care. Understanding the procedure, costs, recovery, risks, and FAQs helps patients navigate this treatment confidently. Consult an interventional neuroradiologist for personalized guidance and optimal outcomes.
Looking for Best Hospitals for Cerebral Angiography with Embolization
Note: we are not promoting any hospitals
we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
1,50,000 |
3,50,000 |
Ahmedabad |
2,00,000 |
4,00,000 |
Ajmer |
1,50,000 |
3,50,000 |
Aligarh |
1,50,000 |
3,50,000 |
Allahabad |
1,50,000 |
3,50,000 |
Amritsar |
1,75,000 |
3,75,000 |
Aurangabad |
1,75,000 |
3,75,000 |
Bangalore |
2,00,000 |
4,00,000 |
Bareilly |
1,50,000 |
3,50,000 |
Belgaum |
1,75,000 |
3,75,000 |
Bhopal |
1,75,000 |
3,75,000 |
Bhubaneswar |
1,75,000 |
3,75,000 |
Bikaner |
1,50,000 |
3,50,000 |
Chandigarh |
2,00,000 |
4,00,000 |
Chennai |
2,00,000 |
4,00,000 |
Coimbatore |
2,00,000 |
4,00,000 |
Dehradun |
1,75,000 |
3,75,000 |
Delhi |
2,00,000 |
4,00,000 |
Dhanbad |
1,50,000 |
3,50,000 |
Durgapur |
1,50,000 |
3,50,000 |
Faridabad |
2,00,000 |
4,00,000 |
Ghaziabad |
2,00,000 |
4,00,000 |
Gorakhpur |
1,50,000 |
3,50,000 |
Guntur |
1,75,000 |
3,75,000 |
Gurgaon |
2,00,000 |
4,00,000 |
Guwahati |
1,75,000 |
3,75,000 |
Gwalior |
1,50,000 |
3,50,000 |
Hyderabad |
2,00,000 |
4,00,000 |
Indore |
1,75,000 |
3,75,000 |
Jabalpur |
1,50,000 |
3,50,000 |
Jaipur |
2,00,000 |
4,00,000 |
Jalandhar |
1,75,000 |
3,75,000 |
Jamshedpur |
1,75,000 |
3,75,000 |
Jodhpur |
1,50,000 |
3,50,000 |
Kanpur |
1,50,000 |
3,50,000 |
Kochi |
2,00,000 |
4,00,000 |
Kolkata |
2,00,000 |
4,00,000 |
Kollam |
1,75,000 |
3,75,000 |
Lucknow |
1,75,000 |
3,75,000 |
Ludhiana |
2,00,000 |
4,00,000 |
Madurai |
1,75,000 |
3,75,000 |
Mangalore |
1,75,000 |
3,75,000 |
Meerut |
1,50,000 |
3,50,000 |
Moradabad |
1,50,000 |
3,50,000 |
Mumbai |
2,00,000 |
4,00,000 |
Mysore |
2,00,000 |
4,00,000 |
Nagpur |
1,75,000 |
3,75,000 |
Nashik |
1,75,000 |
3,75,000 |
Navi Mumbai |
2,00,000 |
4,00,000 |
Noida |
2,00,000 |
4,00,000 |
Patna |
1,50,000 |
3,50,000 |
Pune |
2,00,000 |
4,00,000 |
Raipur |
1,75,000 |
3,75,000 |
Rajkot |
1,75,000 |
3,75,000 |
Ranchi |
1,50,000 |
3,50,000 |
Surat |
2,00,000 |
4,00,000 |
Thane |
2,00,000 |
4,00,000 |
Vadodara |
1,75,000 |
3,75,000 |
Varanasi |
1,50,000 |
3,50,000 |
Visakhapatnam |
1,75,000 |
3,75,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.