Cerebral Angiography with Embolization

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Things you need to know

1.What is ​Cerebral Angiography with Embolization?
2.Why do you need it?
3.Why cost vary in philippines?
4.Surgery cost range by city
5.Surgery Procedure
6.Recovery
7.Risk and complications
8.FAQ
9.Conclusion

What is Cerebral Angiography with Embolization?

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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 Philippines?

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Cerebral Angiography with Embolization Procedure

  1. Before Procedure Evaluation:
    • Diagnosis:
    • 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.
  2. 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.
    • The catheter is removed, and the groin/wrist site is closed (manual pressure or closure device).
  3. 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

  1. Hospital Stay: 1–3 days (unruptured); 1–2 weeks (ruptured or complications).
  2. 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.
  3. Diet: Normal diet; 2–3 liters water daily to flush contrast dye.
  4. 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

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Looking for Best Hospitals for Cerebral Angiography with Embolization

Note: we are not promoting any hospitals

We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)

  • click on your city and schedule your surgery now done in good hands.
City Minimum Price (₱) Maximum Price (₱)
Angeles City
Antipolo
Bacolod
Bacoor
Baguio
Butuan
Cagayan de Oro
Caloocan
Cebu City
Dasmariñas
Davao City
General Santos
General Trias
Iligan
Iloilo City
Las Piñas
Makati
Malolos
Manila
Muntinlupa
Parañaque
Pasay
Pasig
Puerto Princesa
Quezon City
San Fernando
San Jose del Monte
Taguig
Valenzuela
Zamboanga City

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.

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 using contrast dye and fluoroscopy, while embolization therapeutically occludes targeted vessels to prevent rupture, bleeding, or other complications. In the Philippines, this procedure is performed in interventional neuroradiology or neurosurgery departments at hospitals like St. Luke’s Medical Center, Makati Medical Center, The Medical City, and Philippine General Hospital (PGH), offering advanced care at relatively affordable costs. Understanding the procedure, costs, recovery, risks, and frequently asked questions (FAQs) is crucial for Filipino patients and families to make informed decisions.

Why Do You Need Cerebral Angiography with Embolization?

Cerebral angiography with embolization is indicated for:

  • Cerebral Aneurysms: To prevent rupture or treat ruptured aneurysms as an alternative to surgical clipping or coiling (20–30% of cases).

  • Arteriovenous Malformations (AVMs): Abnormal artery-vein connections risking hemorrhage (10–15% of cases; 2–3% annual bleeding risk if untreated).

  • Dural Arteriovenous Fistulas (dAVFs): Abnormal connections causing symptoms like pulsatile tinnitus, headaches, or hemorrhage risk (5–10%).

  • Tumor Embolization: Pre-surgical embolization of vascular tumors (e.g., meningiomas, 5–10%) to reduce intraoperative bleeding.

  • Carotid-Cavernous Fistulas (CCFs): To treat symptoms like vision loss, proptosis (bulging eye), or eye redness (5% of cases).

  • Acute Ischemic Stroke: Rarely, to embolize a bleeding source post-thrombolysis (<5%).

  • Prevalence in the Philippines: Brain vascular abnormalities are relatively rare but significant, with ~1,000–2,000 cases annually requiring embolization, often linked to hypertension, trauma, or congenital factors.

  • Timing: Urgent for ruptured aneurysms (within hours to days); elective for unruptured high-risk lesions or symptomatic AVMs/dAVFs.

The procedure aims to occlude abnormal vessels, reduce hemorrhage risk, or facilitate further treatment (e.g., surgery, radiosurgery) while preserving normal brain vasculature.

Why Do Cerebral Angiography with Embolization Costs Vary in the Philippines?

Costs range from ₱200,000 to ₱700,000, influenced by:

  • Procedure Complexity:

    • Simple embolization (e.g., small aneurysm with coils): ₱200,000–₱400,000.

    • Complex cases (e.g., large AVMs, multiple sessions): ₱400,000–₱700,000.

  • Hospital/Location: Higher costs in Metro Manila private hospitals (e.g., St. Luke’s, Makati Medical Center: ₱300,000–₱700,000); lower in public hospitals like PGH (₱80,000–₱250,000, often subsidized by PhilHealth or PCSO medical assistance).

  • Surgeon’s Expertise: Experienced interventional neuroradiologists charge higher fees.

  • Additional Costs:

    • Embolic agents (e.g., Onyx, NBCA glue, platinum coils): ₱50,000–₱200,000.

    • Pre-op imaging (e.g., CT angiography, MRI/MRA): ₱10,000–₱30,000.

    • Anesthesia (local with sedation or general): ₱20,000–₱50,000.

    • Hospital stay (1–3 days, or 1–2 weeks for ruptured cases): ₱10,000–₱30,000/day.

    • ICU (if needed, 1–3 days): ₱20,000–₱50,000/day.

    • Medications (e.g., analgesics, anti-seizure drugs): ₱5,000–₱20,000.

  • Insurance: PhilHealth covers part (e.g., ₱30,000–₱100,000) for symptomatic or high-risk conditions; private insurance typically covers medically necessary cases. PCSO medical assistance or charity programs may reduce costs for indigent patients. Confirm with your provider.

Cerebral Angiography with Embolization Procedure

Before Procedure Evaluation:

  • Diagnosis:

    • Imaging: CT angiography (CTA), MRI, or magnetic resonance angiography (MRA) identifies the vascular abnormality (e.g., aneurysm size, AVM nidus, 80–90% of cases).

    • Symptoms: Vary by condition:

      • Aneurysms: Severe headache, neurological deficits (ruptured, 20–30%).

      • AVMs: Seizures, headaches, or hemorrhage (10–15%).

      • dAVFs: Pulsatile tinnitus, vision changes (5–10%).

      • CCFs: Proptosis, eye redness, vision loss (5%).

    • Blood Tests: Kidney function (for contrast dye safety), coagulation (e.g., INR), blood sugar, and infection screening.

  • Preparation: Stop blood thinners (e.g., aspirin, clopidogrel) 5–7 days prior if safe; control blood pressure (<140/90 mmHg); fasting 4–6 hours. Consent includes risks like stroke or vessel perforation.

  • Multidisciplinary Team: Involves interventional neuroradiologist, neurosurgeon (for backup), anesthesiologist, and neurologist (for post-op care).

Procedure:

  1. Cerebral Angiography:

    • Performed under local anesthesia with sedation (70–80%) or general anesthesia (20–30%, e.g., uncooperative patients or children), lasting 1–3 hours.

    • Process:

      • A catheter is inserted via the femoral artery (groin, 90%) or radial artery (wrist, 10%) and guided to the brain’s arteries (e.g., carotid, vertebral) using fluoroscopy (real-time X-ray).

      • Contrast dye is injected to visualize vessels, creating a detailed angiogram to map the abnormality (e.g., aneurysm neck, AVM feeding arteries).

    • Tools: Fluoroscopy machine, diagnostic catheter, contrast dye (iodinated).

  2. Embolization:

    • A microcatheter is advanced to the target vessel (e.g., aneurysm sac, AVM nidus).

    • Embolic Agents:

      • Liquid Agents: Onyx, NBCA (glue) for AVMs or fistulas (30–40% of cases).

      • Coils: Platinum coils for aneurysms (50–60%, similar to coiling).

      • Particles: PVA particles for tumor embolization (5–10%).

    • The agent occludes the abnormal vessel, reducing blood flow while preserving normal vasculature.

    • A post-embolization angiogram confirms occlusion and checks for complications (e.g., unintended vessel blockage).

    • The catheter is removed; the access site is closed with manual pressure or a closure device (e.g., Angio-Seal).

  3. Intraoperative Tools:

    • Microcatheter: Delivers embolic agents with precision.

    • Fluoroscopy: Guides catheter navigation.

    • Doppler ultrasound: Confirms vessel occlusion intra-op.

After Procedure:

  • Monitoring: 6–12 hours of bed rest with leg immobilization (femoral access) to prevent groin hematoma; neurological checks for stroke signs (e.g., weakness, speech difficulty).

  • Hospital Stay: 1–3 days for unruptured cases; 1–2 weeks for ruptured cases or complications.

  • Care:

    • Pain management with oral analgesics (e.g., paracetamol) for groin discomfort (1–2 days).

    • IV fluids to flush contrast dye and protect kidneys (2–3 liters/day).

    • Medications: Anti-seizure drugs (e.g., levetiracetam for AVMs, 10–20%), aspirin (for stents/coils, 1–3 months).

  • Instructions: Avoid heavy lifting or strenuous activity for 1–2 weeks; monitor for neurological changes (e.g., headache, vision loss).

Recovery After Cerebral Angiography with Embolization

  • Hospital Stay: 1–3 days (unruptured cases); 1–2 weeks (ruptured cases or complications).

  • Post-Procedure Care:

    • Pain: Mild groin soreness for 2–3 days; managed with analgesics.

    • Activity: Bed rest for 6–12 hours post-procedure; resume light activities (e.g., walking) in 2–3 days; avoid heavy lifting for 1–2 weeks.

    • Neurological Monitoring: For deficits (e.g., weakness, speech/vision changes), indicating possible stroke or bleeding.

    • Diet: Normal diet; drink 2–3 liters of water daily for 1–2 days to flush contrast dye.

    • Medications: Aspirin (75–150 mg, for stents/coils), anti-seizure drugs (e.g., for AVMs), or blood pressure control as needed.

  • Follow-Up:

    • Visit at 1–2 weeks to check access site and neurological status.

    • Imaging (e.g., angiogram, MRI/MRA) at 3–6 months to confirm occlusion and monitor for recurrence (10–20% for AVMs).

    • Annual follow-ups for high-risk cases (e.g., large AVMs).

  • Recovery timeline: Most resume normal activities in 1–2 weeks (unruptured) or 4–6 weeks (ruptured). Success rates: 85–95% for complete aneurysm occlusion; 60–80% for AVM size reduction (may require multiple sessions or surgery/radiosurgery).

Risks and Complications

  • Procedure Risks:

    • Stroke (2–5%): Due to clot formation, embolism, or vessel occlusion; causes weakness, speech, or vision deficits.

    • Vessel Perforation (1–3%): Risking intracranial hemorrhage; may require emergency surgery.

    • Groin Hematoma (2–5%): Bleeding at femoral access site; may need compression or drainage.

    • Contrast-Related: Kidney injury (<1%, higher in diabetics or kidney disease), allergic reaction to dye (rare, <1%).

  • Post-Procedure:

    • Rebleeding (1–3%): If occlusion is incomplete (e.g., residual AVM nidus); requires retreatment.

    • Neurological Deficits (3–5%): Temporary or permanent weakness, vision, or speech issues; managed with rehab or medications.

    • Infection (<1%): At access site; treated with antibiotics.

    • Seizures (1–2%): Especially with AVMs; managed with anti-seizure drugs.

  • Long-Term:

    • Recurrence (5–15%): Higher with AVMs or dAVFs; may need additional embolization, surgery, or radiosurgery (₱200,000–₱500,000).

    • Radiation Exposure: From fluoroscopy; minimal risk but cumulative with multiple procedures.

  • Report severe headache, sudden weakness, vision changes, or groin swelling promptly.

Frequently Asked Questions (FAQs)

What causes brain vascular abnormalities?
Aneurysms: Hypertension, smoking, genetics. AVMs/dAVFs: Often congenital, sometimes post-trauma. CCFs: Trauma or spontaneous. Tumors: Abnormal vascular growth.

Can embolization cure the condition?
Aneurysms: Often curative (85–95% complete occlusion). AVMs/dAVFs: Reduces size/risk (60–80% success) but may require surgery or radiosurgery for complete cure.

Is the procedure painful?
Minimal discomfort at the groin site; sedation or anesthesia ensures comfort during the procedure.

How soon can I resume activities?
Light activities: 2–3 days; normal routines: 1–2 weeks (unruptured); 4–6 weeks (ruptured or complex cases).

Is cerebral angiography with embolization covered by insurance in the Philippines?
PhilHealth covers part (e.g., ₱30,000–₱100,000) for symptomatic or high-risk conditions; private insurance typically covers medically necessary cases. PCSO assistance may apply. Confirm with your provider.

What are the signs of complications post-procedure?
Severe headache, sudden weakness, vision changes, speech difficulty, or groin swelling require immediate medical attention.

Can the abnormality recur?
Yes, 5–15% risk, especially with AVMs or dAVFs; regular imaging follow-up (e.g., MRI/MRA) is needed.

What lifestyle changes are needed post-procedure?
Manage blood pressure, quit smoking, avoid heavy lifting for 1–2 weeks, take prescribed medications (e.g., aspirin, anti-seizure drugs), and attend follow-ups.

Conclusion

Cerebral angiography with embolization is an effective, minimally invasive procedure to treat brain vascular abnormalities, significantly reducing hemorrhage risk or symptoms with a high success rate (85–95% for aneurysms). The Philippines’ top hospitals (St. Luke’s, Makati Medical Center, PGH) offer quality care at costs ranging from ₱200,000 to ₱700,000, often partially covered by PhilHealth or private insurance. Understanding the procedure, costs, recovery, risks, and FAQs empowers patients to approach treatment confidently. For symptoms like severe headache, pulsatile tinnitus, or neurological deficits, seek immediate care at a hospital with an interventional neuroradiology unit. Consult a board-certified 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 do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)

  • click on your city and schedule your surgery now done in good hands.
City Minimum Price (₱) Maximum Price (₱)
Angeles City
100,000
300,000
Antipolo
100,000
300,000
Bacolod
100,000
300,000
Bacoor
100,000
200,000
Baguio
100,000
300,000
Butuan
100,000
200,000
Cagayan de Oro
100,000
300,000
Caloocan
100,000
200,000
Cebu City
150,000
400,000
Dasmariñas
100,000
200,000
Davao City
150,000
400,000
General Santos
100,000
300,000
General Trias
100,000
200,000
Iligan
100,000
300,000
Iloilo City
100,000
300,000
Las Piñas
100,000
300,000
Makati
100,000
400,000
Malolos
100,000
200,000
Manila
150,000
400,000
Muntinlupa
100,000
300,000
Parañaque
100,000
300,000
Pasay
100,000
300,000
Pasig
150,000
400,000
Puerto Princesa
100,000
300,000
Quezon City
150,000
400,000
San Fernando
100,000
200,000
San Jose del Monte
100,000
200,000
Taguig
150,000
400,000
Valenzuela
100,000
200,000
Zamboanga City
100,000
300,000

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.

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