case_images: PMC11834883_01
case_images: (A) Right cerebral angiography. (B) The red line is the right superior cerebellar artery, the yellow line is the perforating branch of the pontine, and the red arrow is a flow-associated aneurysm of the superior cerebellar artery. (C) The red line is the main drainage vein, and the orange, yellow and blue lines are the secondary drainage veins.
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case_images: After admission, the digital signature algorithm (DSA) results revealed the presence of an AVM in the right cerebellar hemisphere (Fig. 1A, Supplementary Fig. 1) involving the right superior cerebellar pontine artery and perforating branch artery as well as flow-related aneurysms in the superior cerebellar artery (Fig. 1B). The AVM drainage vein comprised a short main drainage vein and three secondary drainage veins (Fig. 1C, Supplementary Fig. 2). When the IBP waveform had flattened, the systolic IBP was maintained between 30 and 40 mmHg (Fig. 2B, Supplementary Video 1).
case_images: (A) Basic vital signs of the patient before RVP initiation. (B) Patient's vital signs at a ventricular rate of 180 beats/min. RVP: rapid ventricular pacing.
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case_images: At this point, the IBP was 87/54 mmHg (Fig. 2A) and cerebral oxygen saturation was 75% on the left and 74% on the right side. When the IBP waveform had flattened, the systolic IBP was maintained between 30 and 40 mmHg (Fig. 2B, Supplementary Video 1).
case_images: (A) Total cerebral angiography after embolization. (B) AVM did not appear at all after embolization. (C) The main drainage vein, secondary drainage vein and AVM vascular mass were completely embolized. AVM: arteriovenous malformation.
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case_images: Following two rounds of RVP, repeated multiangle angiography revealed satisfactory embolization (Figs. 3A-C, Supplementary Figs. 3 and 4).