Embolization, AVM

Pre-resection embolization of intracranial AVMs can reduce intraoperative bleeding and facilitate safer nidus dissection.^[1]

Cases

1

One potential complication associated with AVM embolization is the risk of AVM rupture due to elevated pressure generated by the forward flow from the microcatheter. It is imperative for the operator to remain cognizant of the tactile feedback provided by the encountered resistance during the procedure. In the presented case, following the successful embolization of a feeding artery, the Sceptor Mini microcatheter was carefully withdrawn from the vicinity of the nidus into a more proximal part of the feeder, where the balloon (white star) was subsequently inflated. An attempt to further embolize the feeder was impeded by resistance, causing the Onyx (red arrow) to halt its forward movement and resulting in a visible gap (green arrow) between the previously administered Onyx and the new injection. Interestingly, upon slightly deflating the balloon, it was observed that the new Onyx advanced, propelled by the natural blood flow, closing the gap. This phenomenon also indirectly confirmed that the balloon had an excellent occlusion of the artery.