Circumferential flow reduction during percutaneous embolotherapy of extracranial vascular malformations: the "cookie-cutter" technique.
We describe a simple, inexpensive, and very effective method of achieving circumferential flow reduction during direct percutaneous cyanoacrylate embolization of a high-flow vascular malformation of the scalp. By using a plastic "cookie cutter" placed over the lesion and applying various degrees of pressure, both venous outflow from and arterial inflow into the lesion were limited. This flow reduction technique improved both the efficacy and safety of the procedure.
Duncan
Ian C
IC
Unitas Interventional Unit, Centurion, South Africa.
Fourie
Pieter A
PA
D000328:Adult; D015901:Angiography, Digital Subtraction; D001165:Arteriovenous Malformations / Q000175:diagnosis / Q000628:therapy*; D017536:Carotid Artery, Common / Q000002:abnormalities / Q000503:physiopathology / Q000601:surgery; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D009880:Ophthalmic Artery / Q000002:abnormalities / Q000503:physiopathology / Q000601:surgery; D012039:Regional Blood Flow / Q000502:physiology; D012535:Scalp / Q000098:blood supply* / Q000503:physiopathology; D013699:Temporal Arteries / Q000002:abnormalities / Q000503:physiopathology / Q000601:surgery; D014680:Veins / Q000002:abnormalities / Q000503:physiopathology / Q000601:surgery