Intermittent balloon occlusion to favor nidal penetration during embolization of arteriovenous malformations: a technique modification. (13th August 2013)

• Record Type: Journal Article
• Authors: Bank, William O; Stemer, Andrew B; Armonda, Rocco A; Bell, Randy S
• Is Part Of: Journal of neurointerventional surgery. Volume 6:Number 4(2014)
• Page Start: e28
• Page End: e28
• Publication Date: 2013-08-13
• Subjects: Arteriovenous Malformation -- Balloon -- Brain -- Intervention -- Liquid Embolic Material; Nervous system -- Surgery -- Periodicals; Cerebrovascular disease -- Surgery -- Periodicals; 617.48
• DOI: 10.1136/neurintsurg-2012-010637.rep
• Languages: English
• ISSNs: 1759-8478

Abstract

Abstract : Endovascular embolization of brain arteriovenous malformations (AVMs) has improved with liquid occlusive agents, but flow-related and anatomic restrictions limit endovascular capabilities. AVM compartments supplied by leptomeningeal networks and feeding arteries too small and/or tortuous for safe catheterization are rarely penetrated by liquid occlusive agents. A case with both impediments prompted a novel solution. A balloon was inflated across the supply to a lenticulostriate feeder, thereby favoring penetration of the liquid occlusive agent, injected from a different feeding territory, back into the AVM compartment supplied by the temporarily occluded feeder. This technique may reduce the number of embolization stages in large high-flow AVMs and increase the likelihood of achieving complete occlusion. This technique is highly complex and requires meticulous monitoring of multiple events.