2018 年 12 巻 8 号 p. 416-422
Objective: We could cure two cases of arteriovenous fistula (AVF) of the scalp by the pressure cooker technique (PCT).
Case Presentations: Case 1 showed scalp AVF with a direct arteriovenous (AV) shunt between the left posterior auricular artery (PAA) and the left superficial temporal vein (STV), which was also fed by a branch of the left occipital artery (OA). Case 2 showed scalp AVF with a direct AV shunt between the left occipital vein (OV) connected to the left STV and the left OA and left PAA as the collateral feeders. The shunts could be completely occluded by forming a plug using coils and low-concentration n-butyl-2-cyanoacrylat (NBCA) and injecting Onyx with pressure through a non-detachable microcatheter (MC) by the PCT via the left PAA in Case 1 and via the left OA in Case 2. The MC could be removed in both patients.
Conclusion: This technique may be useful if it is applied only to the external carotid artery system, in which adhesion of the MC is manageable, and Onyx injection finishes within a several minutes.