Arteriovenous malformations are difficult lesions to treat whether surgical or catheter occlusive therapy is used. If the major feeders are ligated or blocked, other arteries open quickly to supply the malformation. Isobutyl 2-cyanoacrylate, deposited with a calibrated leak balloon microcatheter, has given satisfactory short term improvement in both the signs and symptoms of two patients with spinal arteriovenous malformations. Superselective placement of the catheter system, a provocative test perfusion of the arteriovenous malformation and its supplying vessels before the acutal occlusion, and high quality fluoroscopy and angiographic equipment added to the safety of the procedure. No long term results are available, but this system may prove itself another tool in the catheter therapist's armamentarium.
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