Curative transvenous embolization for ruptured brain arteriovenous malformations: a single center experience from China.

Related Articles

Curative transvenous embolization for ruptured brain arteriovenous malformations: a single center experience from China.

World Neurosurg. 2018 May 09;:

Authors: He Y, Bai W, Li T, Hui FK, He Y, Xu B

Abstract
OBJECTIVE: To evaluate the feasibility and safety of transvenous embolization treatment for brain arteriovenous malformations (bAVM).
METHODS: Between November 2016 and August 2017, a transvenous endovascular embolization protocol was implemented at the Henan Provincial People's Hospital for consecutive patients with ruptured bAVM. Therapeutic decision making was based on Spetzler-Martin grades, bAVM location, pattern of venous drainage, and angioarchitecture. And the transvenous embolization procedure was combined with transarterial support. Complete angiographic obliteration of the nidus was the objective of treatment.
RESULTS: Among the 10 patients with ruptured bAVM, 8 were males. The Spetzler-Martin grades before the transvenous embolization session were IV for 3 of the 10 patients, III for 5 patients, II for 1 patient, and I for 1 patient. The preprocedural modified Rankin scale score (mRS) was 0-2 for 6 of the 10 patients, and 5 of 10 patients also had deep venous drainage. Arterial blood pressure control management and venous pressure cooker technique were used in all 10 patients; 9 patients had immediate angiographic occlusion, and 2 patients were found with a ventricular hemorrhage, which did not cause any disability after medical treatment. Seven patients underwent angiography 3 to 5 months after operation and complete obliteration of the nidus conformed. The median clinical follow-up for all 10 patients was 8 months (range 3-12), epilepsy occurred in one patient 3 months after the procedure, and the mRS scores of all patients were ≤1.
CONCLUSIONS: Transvenous embolization of bAVM is feasible and may improve the cure rate. However, the safety and long-term effects need further validation.

PMID: 29753079 [PubMed - as supplied by publisher]

https://ift.tt/2ICicy0