High-Flow Pial AVF: Safety Considerations—Detachable Tip Microcatheter and Proximal Balloon Occlusion Technique

A 27-year-old female presented with headache of 6 months duration. NCCT head revealed high density, extra-axial large vascular sacs in right parieto- occipital region(Fig. 73.1a). DSA showed a very high-flow single-hole pial fistula with large venous sacs, fed by cortical branch of the inferior division of right middle cerebral arteryand draining into superior sagittal sinus(Fig. 73.1b, c).