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CVIR Endovascular
Fig. 8 | CVIR Endovascular

Fig. 8

From: Endovascular balloon-assisted liquid embolisation of soft tissue vascular malformations: technical feasibility and safety

Fig. 8

Patient 7 (Proximal calf AVM). (A) 4D time resolved imaging of contrast kinetics (TRICKS) MRA showing a diffuse AVM in the proximal calf with a nidus (arrowhead) and fistula components draining into arterialised draining veins (arrows). (B) Axial contrast-enhanced T2 fat saturated image showing dilated and arterialised superficial draining veins (arrows) over the proximal shin. Following antegrade right CFA access, DSA was performed with a balloon occlusion microcatheter inflated within arterial feeders from the (C) peroneal, (D) posterior tibial and (E) tibioperoneal trunk arteries. In each run, there was opacification of the AVM nidus and no evidence of contrast washout into the draining veins. Polidocanol 3% liquid embolic was injected under fluoroscopic control until nidal staining and stasis was observed. (F) Pre-embolisation DSA showing the nidal blush of the AVM and corresponding arterial feeders. (G) Post-embolisation DSA showing absence of any residual AVM nidus. (H) Follow-up MRA 8 weeks post-embolisation in the late arterial phase showing complete resolution of the AVM nidus and absence of early venous filling

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