Clipping of an AVM arterial feeder through a burr hole prior to radical surgery. Technical note

If the main feeder of an arteriovenous malformation (AVM) is a branch of the middle cerebral artery, one segment of which lies on the brain surface, it is advisable to clip it through a burr hole placed at an angiographically preselected point. The technical details of the procedure are described. This simple maneuver performed directly prior to radical surgery decreases the risk of possible rupture of an AVM during craniotomy and facilitates radical AVM excision.