Balloon occlusion to reduce outflow and further embolization with ethanol from microcatheter inserted from the balloon catheter. ( This allows baseline necessarily mean and systolic pulmonary arterial stress measurements. Vasodilator therapy, generally milrinone, is administered if pulmonary arterial pressures increase to increased than 25 mm Hg in contrast with baseline values. https://www.sgvascularctr.com/understanding-venous-malformation-treatments-in-singapore/