LABORATORY SIMULATIONS AND TRAINING IN ENDOVASCULAR EMBOLOTHERAPY WITH A SWINE ARTERIOVENOUS MALFORMATION MODEL

We assessed the suitability of a swine experimental arteriovenous malf ormation model for laboratory simulations and training in endovascular embolotherapy, Embolizations with liquid glue or particles were perfo rmed in 10 animals. The parameters of injection (microcatheter positio n, concentration and volume of embolic agent, injection rate) were del iberately varied to simulate results that may be observed in clinical practice. A range of successful and less desirable therapeutic outcome s or complications was simulated. In one model, intravascular mean blo od pressure in the ''terminal feeder'' rose after ''nidus'' embolizati on, consistent with observations in feeders of cerebral arteriovenous malformations. Experience in the technical aspects of embolotherapy wa s gained by repeated performances using this model. Simplicity of crea tion, clear angiographic visibility of feeders, a nidus and a draining vein, and hemodynamic similarities with cerebral arteriovenous malfor mations make this an attractive in vivo experimental model for learnin g the principles of embolotherapy, testing new embolic agents, and tra ining/gaining experience in embolization techniques.