The safe and effective placement of the microcatheter is the primary condition for AVM embolization. To accurately and selectively send the microcatheter into the supplying artery to the malformation mass, two techniques can be applied: ① Blood flow steering technology; ② Microguide wire guide cited technology.
(1) Blood flow guidance technology: suitable for floating microcatheter in place, using arterial blood flow to push the tip of the soft floating microcatheter along the route artery and through the supply artery to reach the malformed blood vessel group or the target position. During the advancement of the microcatheter, it can By injecting contrast medium or saline, the direction of the tip of the microcatheter is changed so that it enters the target vessel.
(2) Micro-guide wire guidance technology: guide the micro-catheter forward with the matching micro-guide wire, increase the support force of the micro-catheter at the same time, and guide the micro-catheter to the target position. During the operation, pay attention to prevent the micro-guide wire from piercing the blood vessels along the path.
In conclusion, according to the embolization strategy of AVM and the condition of the path vessels, a floating microcatheter or a microguidewire-guided microcatheter can be selected that are compatible with the above two techniques. Making full use of the road map is the basic method to successfully complete the above two techniques. After the microcatheter is in place, repeated multi-angle superselective angiography is required to avoid embolization of normal blood vessels as much as possible.