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
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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.