Related Experiment Video
Updated: Jan 14, 2026
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Modified pressure cooker vs. push-and-plug technique in transarterial embolization for brain arteriovenous
Haojie Wang1,2, Bingsen Xie1,2, Ye Xu1,2
1Department of Neurosurgery, Neurosurgical Research Institute, First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
Objective:
This study retrospectively analyzed patients with brain arteriovenous malformation (bAVM) treated by transarterial curative embolization using either the modified pressure cooker technique (mPCT) or the conventional push-and-plug technique (PPT). The primary objective was to assess mPCT's safety and efficacy by comparing occlusion rates and complications with PPT.
Materials And Methods:
Data were retrospectively collected from all bAVM patients who underwent transarterial curative embolization at our institution between April 2019 and April 2023. A total of 188 patients were included, with 61 treated using the mPCT and 127 with the PPT. Baseline characteristics, angiographic and clinical outcome, complications and follow-up data were systematically evaluated and analyzed. Lesions were categorized into two groups according to Spetzler-Martin grade (SMG): SMG I-III and SMG IV-V. Furthermore, multivariable logistic regression was performed to identify independent risk factors for incomplete obliteration.
Results:
Baseline characteristics were well balanced between the two groups. Immediately after the procedure, the mPCT group achieved a complete obliteration rate of 49.2% compared with 34.6% in the PPT group (p = 0.056). Subgroup analysis demonstrated a markedly higher immediate complete obliteration rate in SMG I-III lesions treated with mPCT (62.5% vs. 40.1%; p = 0.018). Overall complication rates did not differ significantly between groups (19.7% vs. 23.6%; p = 0.543). On multivariable analysis restricted to the mPCT group, nidus size >3 cm was an independent predictor of incomplete obliteration (OR = 14.042, 95% CI: 2.126-92.739; p = 0.006).
Conclusion:
Overall, occlusion rates did not differ significantly between mPCT and PPT, but mPCT achieved higher rates in SMG I-III lesions with comparable complication rates, suggesting potential benefits in selected cases that require confirmation in larger prospective cohorts with longer follow-up.
