Determination of Vascular Geometry and Flow Velocity in Cerebral Arteriovenous Malformations (AVMs) Using Double Contrast and High-Speed Digital Subtraction Angiography

Successful therapeutic embolization, i.e., catheter-based occlusion of cerebral arteriovenous malformations (AVMs) using liquid embolic agents requires precise knowledge of highly variant AVM architecture, blood flow velocity, and transit times through the AVM fistulae. In this study we tried to visualize both the AVM vascular substructure and dynamics of discrete microdroplets traveling through the AVM using a single injection composed of both soluble and non-soluble contrast material. The contrast injection is traced with high-speed digital subtraction angiography. This novel technique serves as a valuable diagnostic tool to the interventionist prior to embolization of the AVM.