Transvenous AVM Embolization-Demetrius K. Lopes, MD, FAANS Video

Video Transcription

Video Summary

The video discusses the transvenous embolization of arteriovenous malformations (AVMs). The speaker talks about the concept of complete embolization of AVMs, known as EmboCure, and its use in clinical settings. They also mention the importance of the venous approach in achieving EmboCure, as it allows for better treatment of different anatomies and AVM architectures.<br /><br />The speaker emphasizes the importance of defining EmboCure as a treatment that shows no early venous filling and no enhancement on MRI with contrast. They discuss the challenges of using embolization alone for AVM treatment, noting that the success rate is less than 50% when using only the arterial approach. They explain that the venous approach can overcome these limitations and improve the rate of EmboCure.<br /><br />Different techniques and tools for reducing reflux and controlling arterial flow during embolization are discussed, including the use of pressure cooker techniques, acrylic plugs, coils, and dual lumen balloons.<br /><br />The speaker mentions their own experiences with transvenous embolization, including cases where arterial access was limited and the venous approach was necessary. They also discuss the use of imaging, such as 3D and 4D DSA, to better understand AVM anatomy and plan embolization procedures.<br /><br />Several case examples are presented to illustrate the use of transvenous embolization in AVM treatment, including cases with partial embolization from the arterial side and subsequent complementation with the venous approach. The speaker discusses the importance of follow-up angiography and MRIs to confirm the success and durability of embolization treatments.<br /><br />The video concludes by highlighting the evolving nature of transvenous embolization and the potential benefits of new technologies and imaging techniques. The speaker emphasizes the need to standardize treatment approaches and further research the impact of transvenous embolization on AVMs.

Keywords

transvenous embolization

arteriovenous malformations

EmboCure

venous approach

embolization techniques

AVM treatment

imaging techniques