I think my issues were to do with how big a change the embo made to my head. Before I had the op, I had a flow into my right transverse sinus, which is a major horizontal vein across the back of your head. Your sagittal sinus comes down the back of your head to the middle, meets the short sinus that is coming from within and splits into the two transverse sinuses which then flow down past each ear as the sigmoid sinuses. The consequence of the high flow into my right TVS was that I was getting “retrograde” flow back up probably the sigmoid sinus, and higher pressure past my ears and maybe even retrograde into my short sinus. So I felt really quite dizzy with all that going on. When the embo was done, everything was very upset by the glue and the contrast but the feeling of dizziness didn’t go away as quickly as I expected and I had what I took to be a bit of a relapse about 6 months afterwards but the docs concluded it was all just still settling down and nothing untoward could be seen on subsequent scans.
In terms of success rate / complications, my doc told me that I had a 5% risk of “bad stuff happening” (i.e. stroke, including death) during the procedure. He didn’t separate that out into 5% complications and 1% death or anything like that but my reading of it was that that means that one in twenty of his patients have something go awry. I was one of the nineteen.
The risks with an embolization are those the same as for an angiogram (e.g. risk that the catheter or guide rupture the artery) plus the risk of a bit of glue flowing to where you didn’t want it to go. I do think there is a bit of science to the mix of onyx used as to how quickly it goes off (solidifies) and how fast a flow you have at the site, so the doc does need to be appropriately adept at dropping the glue at the right point, in the right way to do everything intended without glueing up something unintended. There’s a lot of timing involved in the procedure. I read here recently of someone whose catheter got stuck in the glue but I think that is very rare.
I am quite sure it is just as complex to go and have a craniotomy (probably more so) as to do something like this, so I still look upon embolization as lower risk than that. In my mind, the key questions were:
Do I think I need the operation? If we left it alone, would it be better or worse?
Am I confident in the doctor who is doing the work?
In my case, I was completely convinced that my DAVF was developing quite quickly and my symptoms were worsening month by month (not year by year) so question 1 was a “yes”. And when I met the consultant interventional radiologist, he had a strange bedside manner but he stuck me as more of an “engineer” than a psychologist: knew exactly what he was going to do mechanically to my head but wasn’t switched on to any emotional needs I might have. “I’ll take the engineer!” I thought. It doesn’t matter if he’s not really taking me on a comfortable journey: if I need to trust my brain to someone, I think this is the man.
So it was.
I’d do it again if needed. Honestly. It was a perfectly gettable-throughable thing. I was as bothered as anything beforehand but I got through it fine and I’d say most of my worries were simply about the unknown.
Hope this helps,