title: Two microcatheter technique for embolization of arteriovenous fistula with liquid embolic agent.
abstract: Problem with embolization of arteriovenous fistula (AVF) with liquid embolic agent is its over-penetration into the veins or regurgitation to the proximal feeder without reaching the shunt point. We present a technique that controls the flow of AVF during embolization. Two microcatheter technique consists of positioning one microcatheter close to the AVF for embolization, and with another microcatheter at the proximal feeding artery to control the AVF flow by coiling. Selective angiograms obtained using a distally positioned microcatheter before and after coiling, were compared how much stagnant effect was achieved. Using two microcatheter technique, AVF occlusion was achieved with good penetration of glue to the venous side of the AVF. Its advantage is the ability to push glue into the shunt without causing over-penetration of glue or its reflux along the feeder. Two microcatheter technique was safe and effective in glue embolization of AVF and also expected to be applied with other liquid embolic agent like Onyx.
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea. ; Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Lin-Bo
authors.initials: LB
authors.lastname: Zhao
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Shim
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Dong-Geun
authors.initials: DG
authors.lastname: Lee
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Dae Chul
authors.initials: DC
authors.lastname: Suh
keywords: Arteriovenous fistula; Catheters; Embolization, Therapeutic/methods