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  • The retrograde pressure cooker technique for transvenous embolization of a residual arteriovenous malformation following stereotactic radiosurgery

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Technical video
The retrograde pressure cooker technique for transvenous embolization of a residual arteriovenous malformation following stereotactic radiosurgery
  1. How-Chung Cheng1,2,
  2. Emily Chung1,
  3. Syed Uzair Ahmed1,3,
  4. Pascal Mosimann1
    1. 1 Joint Department of Medical Imaging, Toronto Western Hospital Division of Neuroradiology, Toronto, Ontario, Canada
    2. 2 Division of Neurosurgery, Department of Surgery, Fu Jen Catholic University Hospital, New Taipei City, Taiwan
    3. 3 Division of Neurosurgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
    1. Correspondence to Dr How-Chung Cheng; vionishc{at}gmail.com

    Abstract

    Residual brain arteriovenous malformations (BAVMs) following stereotactic radiosurgery are not uncommon and the optimal subsequent management remains undetermined.1–3 Endovascular embolization has been reported as an effective treatment for residual BAVMs after radiosurgery,4 5 and has the advantage over repeat radiosurgery in selected cases as angiographic weak points can be secured immediately and the risk of radiation-induced complications is less of a concern.6 7 In this technical video (video 1), we demonstrate the transvenous embolization of a previously-irradiated arteriovenous malformation and a persistent venous pouch using the retrograde pressure cooker technique, with emphasis on the important recommendations for avoiding periprocedural complications.

    Video 1 Video demonstrating Onyx embolization of the residual brain arteriovenous malformation using the retrograde pressure cooker technique
    • Arteriovenous Malformation
    • Angiography
    • Liquid Embolic Material

    https://doi.org/10.1136/jnis-2024-022035

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      Footnotes

      • Contributors Conception and design: HC, PM. Preparing the video: HC, EC. Final approval: all authors.

      • 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 None declared.

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

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