Brain Arteriovenous Malformation Embolization Using Detachable-tip Microcatheter

Abstract

Detachable-tip microcatheters are widely used for brain arteriovenous malformation (AVM) embolization. They have significant advantages. First, the risk of catheter entrapment with Onyx is low and less tension is needed for detachment of the tip when compared to the retrieval of nondetachable-tip microcatheters, which is associated with a lower risk of vessel rupture during retrieval. Second, long reflux of embolization material is allowed to create a firm plug, which makes it possible to obtain better lesion penetration. Third, the pressure-cooker technique or the transvenous approach using detachable-tip microcatheters has increased the number of AVMs that could be cured by embolization alone. Detachable-tip microcatheter is an indispensable tool for AVM embolization especially with Onyx since the catheter increases the safety and efficacy of the procedure. However, more aggressive embolization may lead to complications. It is always important to analyze the angioarchitecture of AVM thoroughly and discuss the management in a multidisciplinary team to determine the aim and goal of each embolization procedure and to avoid complications.