Objective: To report an operative technique using 2 microcatheters placed in different arterial pedicles for Onyx (ev3 Neurovascular, Inc, Irvine, CA) embolization of cerebral arteriovenous malformations (AVMs).
Technique: Two cases illustrate this approach to embolization of AVMs. Microcatheters are placed in 2 different arterial pedicles of the AVM. Subsequently, the embolic material is injected in an alternate fashion between the microcatheters until occlusion of the AVM.
Conclusion: The 2-microcatheter technique for embolization of AVMs with Onyx was performed safely. The technique allowed for less interruptions of injection and better control of the reflux of Onyx in the arterial pedicle during treatment. This technique presents an alternate approach to conventional AVM embolization.