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Efficacy of Pressure Cooker Technique in Redo Embolization for High-Flow Torcular Dural Sinus Malformation
Frank Gleb Solis Chucos1, Rosa Lizbeth Ecos Quispe2,3, Mauro Toledo1
1Department of Endovascular Neurosurgery, Instituto Nacional de Salud del Niño-San Borja, Lima, Perú.
Abstract:
Torcular dural sinus malformations (tDSMs) with high-flow fistulas pose complex management challenges due to their vascularity and the delicate neuroanatomy involved. This report presents the case of a child with tDSM and hydrocephalus, who underwent 3 staged embolization procedures but required a redo intervention due to residual malformation and venous hypertension. Utilizing the pressure cooker technique (PCT) in a redo setting allowed for high-pressure, targeted embolic delivery with minimized reflux, achieving near-complete occlusion and significant symptom relief. This case highlights PCT's potential to improve outcomes in multi-stage treatments of high-flow tDSM, reducing reflux and enhancing safety in technically demanding cases.
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