Transfemoral Approach for Intraoperative Angiography in the Prone or Three-quarter Prone Position: A Revisited Protocol for Intracranial Arteriovenous Malformation and Fistula Surgery

Purpose Among the different arterial accesses, the femoral access is the main approach for intraoperative angiography (IOA) performed in a prone position. Without a standardized protocol, however, the application of prone IOAs in intracranial arteriovenous malformation (AVM) or arteriovenous fistula (AVF) surgery remains limited by its procedural complexity. This study describes the detailed protocol for prone IOA through a transfemoral approach and highlights several refinements in preparing this procedure.