The pressure cooker technique for the treatment of brain AVMs

J Neuroradiol. 2014 Mar;41(1):87-91. doi: 10.1016/j.neurad.2013.10.001. Epub 2014 Jan 7.


Arteriovenous malformations (AVMs) may be cured by injecting liquid embolic agents such as Onyx. Reflux, however, can sometimes be difficult to control and may jeopardize a complete embolization. The pressure cooker technique (PCT) was designed to create an anti-reflux plug by trapping the detachable part of an Onyx-compatible microcatheter with coils and glue in order to obtain wedge-flow conditions, thereby enabling a better understanding of macrofistulous AVMs and a more comprehensive, forceful and controlled Onyx embolization. The PCT might enlarge the range of AVMs amenable to endovascular cure. Three illustrative cases are presented.

Keywords: Brain AVM; Coils; Embolization; Glue; Onyx; Pressure cooker.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Dimethyl Sulfoxide / administration & dosage*
  • Embolization, Therapeutic / instrumentation*
  • Embolization, Therapeutic / methods*
  • Enbucrilate / administration & dosage*
  • Equipment Design
  • Equipment Failure Analysis
  • Female
  • Hemostatics / administration & dosage*
  • Humans
  • Injections, Intravenous / instrumentation
  • Intracranial Arteriovenous Malformations / diagnostic imaging
  • Intracranial Arteriovenous Malformations / therapy*
  • Male
  • Middle Aged
  • Polyvinyls / administration & dosage*
  • Pressure
  • Radiography
  • Tissue Adhesives / administration & dosage
  • Treatment Outcome
  • Vascular Access Devices*
  • Young Adult


  • Hemostatics
  • Onyx copolymer
  • Polyvinyls
  • Tissue Adhesives
  • Enbucrilate
  • Dimethyl Sulfoxide