PT - JOURNAL ARTICLE AU - Cheng, How-Chung AU - Bodani, Vivek P AU - Chung, Emily AU - Mosimann, Pascal John TI - Transvenous retrograde pressure cooker technique for embolization of an ethmoidal dural arteriovenous fistula AID - 10.1136/jnis-2023-020393 DP - 2024 Jul 01 TA - Journal of NeuroInterventional Surgery PG - 742--742 VI - 16 IP - 7 4099 - http://jnis.bmj.com/content/16/7/742.short 4100 - http://jnis.bmj.com/content/16/7/742.full SO - J NeuroIntervent Surg2024 Jul 01; 16 AB - Ethmoidal dural arteriovenous fistulas (DAVFs) are rare lesions, accounting for approximately 10% of intracranial DAVFs.1 2 As ethmoidal DAVFs commonly demonstrate cortical venous drainage, treatment is always warranted.2–6 Endovascular transvenous embolization has been increasingly reported as an effective and safe treatment for ethmoidal DAVFs, and since occlusion of the central retinal artery and resulting blindness are not a concern, it has an advantage over transarterial embolization.3–6 To ensure curative embolization, we adopted the transvenous retrograde pressure cooker technique (RPCT), creating a plug with n-butyl cyanoacrylate (NBCA) in the draining vein to allow a more comprehensive and efficient injection of Onyx (Medtronic, MN) while avoiding excessive reflux.7 8 In this technical video (video 1), we report the first case using the transvenous RPCT for successful Onyx embolization of an ethmoidal DAVF, with emphasis on the technical nuances of the RPCT and important tips to avoid periprocedural complications. Video 1  Video demonstrating Onyx embolization of an ethmoidal dural arteriovenous fistula using the transvenous retrograde pressure cooker technique.