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Direct Puncture and Embolization of Vascular Lesions
Alan B. Lumsden, MD Houston Methodist DeBakey Heart & Vascular Center Houston Methodist

Direct puncture and embolization of vascular lesions: important technique for vascular surgeons. INTRODUCTION: We demonstrate 3 cases, where direct puncture and intra-lesional embolization was employed. METHODS: Intraoperative video demonstrates several techniques for direct puncture of highly vascular lesions. RESULTS: Case #1 Ulcerating AVM of thenar eminence. Occluded radial artery precluded a transarterial approach. Angiography used to road map the AVM and butterfly needles used to directly puncture and embolize the AVM. Case #2 A 12 yo child presented with a massive right upper extremity AVM. Extensive intra humoral AVM required direct embolization using an intraosseous needle. Case #3 Direct tumoral puncture of a huge carotid body tumor was performed to prevent embolization via arterial collateral pathways in several subsequent carotid body tumors. CONCLUSIONS:Direct puncture of vascular tumors is a legitimate approach and a useful technique for vascular


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