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Intermittent balloon occlusion to favor nidal penetration during embolization of arteriovenous malformations: a technique modification.

MedStar author(s):

Citation: Journal of Neurointerventional Surgery. 6(4):e28, 2014 May.PMID: 23943818Institution: MedStar Washington Hospital CenterDepartment: RadiologyForm of publication: Journal ArticleMedline article type(s): Case Reports | Journal ArticleSubject headings: *Arteriovenous Fistula/th [Therapy] | *Balloon Occlusion/mt [Methods] | *Intracranial Arteriovenous Malformations/th [Therapy] | Arteriovenous Fistula/di [Diagnosis] | Arteriovenous Fistula/ra [Radiography] | Female | Humans | Intracranial Arteriovenous Malformations/di [Diagnosis] | Intracranial Arteriovenous Malformations/ra [Radiography] | Magnetic Resonance Angiography | Neuroimaging | Tomography, X-Ray Computed | Young AdultYear: 2014 Local holdings: Available online through MWHC library: 2009 - presentISSN:

1759-8478

Name of journal: Journal of neurointerventional surgeryAbstract: 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.All authors: Armonda RA, Bank WO, Bell RS, Stemer ABFiscal year: FY2014Digital Object Identifier:

http://dx.doi.org/10.1136/neurintsurg-2012-010637.rep

Date added to catalog: 2015-03-17

Holdings ( 1 )
Title notes ( 3 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	23943818	Available		23943818

Available online through MWHC library: 2009 - present

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.

English