[Selection of Devices and Embolic Substances in Endovascular Surgery for Brain Arteriovenous Malformations]

Cerebral vascular surgery for cerebral arteriovenous malformations (cAVMs) is often challenging due to the diversity of lesions. I describe my treatment policy, embolization techniques, selection of embolic substances, and device choice. Proper use of embolization techniques is critical for safety in cAVM procedures. I use coils, NBCA, and Onyx. NBCA is employed when short-distance, reliable feeder occlusion is required. I prefer microcatheters with good contrast properties that are compatible with coils; for very thin feeders, I select microcatheter with a finer diameter. In cAVM embolization, "how to use" is more important than "what to use." I define the purpose of embolization and select the technique and material for each case.