Treatment of high-flow vascular malformations by venous embolization aided by flow occlusion techniques

Transvenous embolization techniques may be helpful as alternatives to the arterial route when treating high-flow vascular malformations. We present our experience using these techniques in four patients. In one patient the venous portion of the arteriovenous malformation (AVM) was punctured directly; in the other three patients it was catheterized via a retrograde venous approach. Flow occlusion techniques were utilized in all patients during embolization, which was performed with absolute alcohol or N-butyl-2-cyanoacrylate. Excellent clinical and angiographic results were obtained, with obliteration of arteriovenous shunting in all patients. There were no complications. The embolization of certain AVMs using a venous approach is a safe and effective treatment.