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Case report
Republished: Multiplug flow control technique as a novel transarterial curative approach for the endovascular treatment of cerebrovascular malformations
  1. H Saruhan Cekirge1,2,
  2. Isil Saatci1
  1. 1 Radiology Department, Private Koru Hospital, Ankara, Turkey
  2. 2 Independent Researcher, Ankara, Turkey
  1. Correspondence to Dr H Saruhan Cekirge; scekirge{at}


Herein, we describe the use of a novel multiplug flow control technique for the curative transarterial embolisation of cerebrovascular malformations using liquid embolic agents (LEAs). The idea behind the use of this technique is to substantially control or arrest flow during LEA injection, with multiple plugs simultaneously formed from microcatheters that are placed within all or multiple feeders, so that the penetration of LEAs is facilitated, with flow control decreasing the washout of a malformation. This technique enables the complete occlusion of a vascular malformation in a shorter injection time than that in other methods because penetration is achieved faster. Details of this technique have been described in the treatment of two cases: one case of unruptured temporal arteriovenous malformation and in the other with a falcotentorial dural arteriovenous fistula, in which the vascular malformations were successfully occluded with transarterial embolisation.

  • arteriovenous malformation
  • angiography
  • brain
  • fistula
  • intervention

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  • Presented at Republished with permission from BMJ Case Reports. Published 31 May 2021; doi:10.1136/bcr-2021-017418.

  • Contributors Both authors conceptualised and applied the technique described; collected the data and analysed; drafted and edited the manuscript. Both authors are approving the manuscript. Corresponding author: HSC.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests HSC: consultancy and proctorship agreements with Medtronic and MicroVention Inc (Aliso Viejo, California, USA), shareholder of NDI Technologies and Vesalio LLC. He is a non-paid member of Siemens Senior Advisory Board. IS: consultancy and proctorship agreements with Medtronic and MicroVention Inc.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.