Percutaneous Direct Puncture Glue Embolization of High-Flow Craniofacial Arteriovenous Lesions: A New Circular Ring Compression Device with a

SUMMARY: The purpose of this study was to evaluate the efficacy of a newly designed circular ring compression device that allows safe and effective glue injection during preoperative embolization of high-flow superficial craniofacial arteriovenous malformations (AVMs). The device was used in 4 cases of craniofacial AVM with multiple feeding arteries and draining veins. It provided a safe glue injection route as well as effective compression of radiating multiple venous drainage routes. Direct-puncture embolization with n-butyl 2-cyanoacrylate(n-BCA) is an effective and safe technique for preoperative devascularization of craniofacial arteriovenous malformations (AVMs).1-3 Both venous outflow and arterial inflow of the lesion should be limited during injection of the embolic material to avoid inadvertent distalmigration of embolicmaterial, including pulmonary embolization and occlusion of venous drainage. Manual compression of the draining vein is usually used for flow reduction.3 However, when an AVM has multiple channels of venous drainage, achieving successful blockage of blood flow is technically difficult withmanual compression. Using a compres