Circumferential Flow Reduction during Percutaneous Embolotherapy of

effective method of achieving circumferential flow reduc-tion during direct percutaneous cyanoacrylate emboliza-tion of a high-flow vascular malformation of the scalp. By using a plastic “cookie cutter ” placed over the lesion and applying various degrees of pressure, both venous outflow from and arterial inflow into the lesion were limited. This flow reduction technique improved both the efficacy and safety of the procedure. Direct percutaneous embolization is a well-estab-lished technique for the treatment of extracranial high-flow and low-flow vascular malformations. We looked for a suitable method of achieving circumferential flow reduction around a superficial high-flow vascular mal-formation of the scalp, not only to avoid inadvertent distal nontarget embolization, including possible occlu