Transvenous Embolization of a Ruptured Arteriovenous Malformation

Transvenous embolization is a not so widely used technique for treatment of arteriovenous malformations.(1,2) However, in the reported cases and series in the literature, it is proven to be a safe and efficient method that can lead to total occlusion of the formation in 1 procedure.(2-5) The transvenous approach is reserved for small, deeply localized formations with a single draining vein.(2-4) In this video, we present a case of a successful single-session transvenous embolization of a ruptured arteriovenous malformation with Onyx. Prior to the injection of the liquid embolic agent, coils were deployed at the proximal part of the draining vein. A balloon was inflated at the arterial part to decrease the pressure inside the nidus, therefore ensuring better penetration of the embolic agent. Control angiogram at the end of the procedure showed total occlusion of the nidus of the arteriovenous malformation.