I’m new to the forum, you can check my intro story on my first post.
Figured I would post this link for anyone wondering what’s new out there in regards to AVM technical advancements.
I had also been told about this after knowingly seeing it online throughout my random online searches, basically a backwards method of embolization in some form.
There is some past information on the study at ncib website or a quick Google search, but the link shown the success on it so far seems to be super promising in reduction of complications.
I’ve read of balloons being used with coils & glue to close off aneurysms (i.e. whereby the balloon is used as a temporary measure to make sure only the aneurysm is closed) but not like this. It sounds like in this case, the embolic agent is injected into the balloon. Interesting!
My cuzin is a neuro and when he told me about it, it’s seems like they are injecting the glue through the drainage vein side, basically blocking the outflow of the drainage to close off the avm, that way avoiding going to multiple feeding pedicles with the risks multiple angios/embos .
He said it’s you need quite the balls to go through it lol but he did not feel to comfortable with it but he also wanted to look into it more.
So quite similar to using a balloon when embolising an aneurysm: you use the balloon to block off the flow while the embolic material sets? Obviously, with embolising an AVM, it doesn’t matter about closing all flow in the vessel you’re trying to embolise but in an aneurysm repair, the closure needs to be very brief, as the general idea there is to bung up the aneurysm but leave the artery fully functional.
Ya well I’m not to sure where the balloons play a role here seems like in some images posted on some studies, the catheter has a set of balloons lined up on it, kinda like booies set in water.
Kool but dunno why it would be safer as they state.
I think it is to basically stop the embolic material going places you don’t want it. I guess injecting that on the arterial side means the flow will take the glue into the AVM (and ideally, narrower passageways, hence bunging up OK). On an aneurysm, the idea is to temporarily close over the mouth of the aneurysm so only the aneurysm fills with glue / coils and when the balloon is removed, the full width of the artery is unimpeded. On a venous injection to an AVM, I guess the flow is against you and rather than narrowing, the natural flow of veins is to flow into wider vessels, so without the balloon the embolic material might flow off somewhere else (more easily than on the arterial side) or again, like the aneurysm, you’re looking to block off one vein but not another where the two join near each other.
… this is how I’ve read about aneurysms and therefore I’m extrapolating to venous AVM treatment (rather than knowing). I’m just guessing. But it makes sense to me that using a balloon to control flow on a venous embolization could make sense / improve likelihood of success and reduce the risk of glueing something you didn’t mean to.
Ya it does make sense in that manner , seems simple enough to uderstand but so complex in the sense of getting and dealing with those vessels when catbered up in there.
I have been looking into this alternative embolisation route a fair bit - a method in which it could be blocked from the drainage would be ideal! Either that or having multi-stage embolisations. Having a MDT meeting on the 9th Jan to discuss this, so will make a post on any updates after then!