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Dynamic (live) 3D roadmap as navigational tool in multiplug brain arteriovenous malformation embolization: technical note

  • Technical Note
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Abstract

Purpose

Treatment of brain arteriovenous malformation (bAVM) includes microsurgical excision, stereotactic radiosurgery, endovascular embolization, or combination. With bAVM embolization, complete angiographic obliteration ranges from 12.5 to 51%, and higher total occlusion rate is seen in SM grades I to III, ranging from 96 to 100%.

Methods

In this paper, we illustrate the use of 3D rotational angiography and dynamic (live) 3D roadmap functions in endovascular treatment of bAVM. A single dynamic 3D roadmap or two dynamic 3D roadmaps obtained help tremendously in navigation of microcatheters and wires along the parent artery and bAVM feeders.

Results

This method eliminates the need for repeated 2D angiograms and roadmaps for new working projections every time the C-arm position is changed for cannulation of different feeders, thereby reducing radiation dose. No instances of misalignment error, vascular perforation, or thromboembolic phenomena were observed in the 21 embolization cases performed within the previous 2 years while utilizing this feature.

Conclusion

The dynamic 3D roadmap is an extremely useful tool for multiple-feeder cannulation, by reducing the use of multiple 2D angiograms, providing intraprocedural live and adjustable 3D roadmap for better mental orientation to angioarchitecture of the bAVM, which further aids in the overall complete angiographic obliteration rate of bAVM in a single session especially in multiplug embolization technique.

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Funding

This study received no commercial or financial funding for its conduction.

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Authors and Affiliations

  1. Department of Neuroradiology, Cerrahpasa Medical Faculty, Istanbul, Turkey

    Bibi Sadaqat R., Bora Korkmazer, Emil Hikmat & Osman Kizilkilic

  2. Department of Radiology, Cam and Sakura State Hospital Istanbul, İstanbul, Turkey

    Kanullah Süleyman

  3. Department of Radiology, Acibadem Maslak Hospital, Istanbul, Turkey

    Naci Kocer & Civan Islak

  4. Department of Anaesthesia, Cerrahpasa Medical Faculty, Istanbul, Turkey

    Ercan Tureci

  5. Interventional X-Ray (iXR), Philips Healthcare, Best, The Netherlands

    Daniel Ruijters

Authors
  1. Bibi Sadaqat R.
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  2. Bora Korkmazer
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  3. Kanullah Süleyman
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  4. Emil Hikmat
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  5. Naci Kocer
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  6. Civan Islak
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  7. Ercan Tureci
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  8. Daniel Ruijters
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  9. Osman Kizilkilic
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Corresponding author

Correspondence to Osman Kizilkilic.

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Conflict of interest

The authors report no conflict of interest concerning the materials and the findings specified in this paper.

Ethical approval

Ethical approval is obtained from the Istanbul University-Cerrahpasa Clinical Research Ethical Committee with date and number as stated:06.04.2023–660506.

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Informed consent is waived in this study.

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R., B.S., Korkmazer, B., Süleyman, K. et al. Dynamic (live) 3D roadmap as navigational tool in multiplug brain arteriovenous malformation embolization: technical note. Neuroradiology 66, 129–133 (2024). https://doi.org/10.1007/s00234-023-03250-6

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  • DOI: https://doi.org/10.1007/s00234-023-03250-6

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