Angiographic assessment of transit times in cerebral arteriovenous malformations prior to NBCA embolization using ethiodol droplets

To improve the n-butyl-2-cyanoacrylate (NBCA) embolization, the flow in arteriovenous malformations (AVMs) was quantified using insoluble contrast material. Superselective microcatheter was placed into feeding pedicles of 8 patients with AVMs and one with a dural arteriovenous fistula. After catheter placement, Amytal testing was made to ensure that the vasculature distal to the catheter tip was not feeding normal brain tissue and no neurological deficits were encountered. In case of a negative Amytal test, therapeutic embolization of the AVM was deemed possible. Ethiodol was injected to obtain the nidus transit time and flow velocity in the AVM. Chest radiography and pulmonary function testing were performed before and after embolization.