Live Case 5
PATIENT 5 - Clinical Data
Spetzler IV AVM to be treated by transvenous embolization
- Spetzler IV frontal AVM
- Previous episode of bleeding and seizures
- Embolization 20 years ago with various materials
- Development of numerous anastomosis via left MCA and meningeal circulation after proximal occlusion of left A2
- Previous embolization of several flow related aneurysms of the posterior circulation
- Embolization within several steps of most indirect feeders from MCA with downgrading of AVM from Spetzler IV to Spetzler I
Occlusion of supply from MCA in several steps
Occlusion of supply from MCA in several steps
Occlusion of supply from MCA in several steps
Occlusion of supply from MCA in several steps
Occlusion of supply from MCA in several steps
Treatment strategy
- Jugular approach
- Navigation with Sonic or Marathon retrogradely through outflow vein
- Microcatheterisation MCA left with Magic for arterial control