Endovascular treatment of cirsoid aneurysms: A stepwise approach to successful embolization

Cirsoid aneurysms, a subtype of arteriovenous fistulas (AVF), of the scalp are rare pathological lesions characterized by abnormal fistulous connections between superficial arteries and draining veins without intervening capillary beds. We present a case report of a cirsoid aneurysm located on the scalp, treated at our tertiary care center using percutaneous endovascular intervention with injection embolics. This report highlights the challenges posed by complex vascular anatomy and high shunt flow in the treatment of such lesions involving the head and neck. We discuss the rationale for selecting the treatment approach, emphasizing the importance of a patient-specific strategy to achieve successful obliteration of the abnormal vascular connections. Our experience underscores the efficacy of transarterial and/or transvenous embolization using appropriate embolic materials in the management of cirsoid aneurysms. This case report contributes to the existing literature on treatment options for scalp AVFs, providing insights into optimizing outcomes in these rare but clinically significant lesions.