Transarterial Embolisation of Cerebral Arteriovenous Malformations

1997 ◽  
Vol 3 (2) ◽  
pp. 119-123 ◽  
Author(s):  
G. Wikholm ◽  
C. Lundqvist ◽  
P. Svendsen
Keyword(s):  
Endovascular Treatment ◽  
Effective Treatment ◽  
Complication Rate ◽  
Arteriovenous Malformations ◽  
Good Health ◽  
Cerebral Arteriovenous Malformations ◽  
Rare Disorders ◽  
Stereotactic Radiation ◽  
The Brain

Arteriovenous malformations of the brain are rare disorders. Embolisation has emerged as an effective treatment with an acceptable, low complication rate. Previously presented results are completed with results from 1994 to 1996. Ninety-six percent of the patients were treated with no or very minor sequelae resulting in total obliteration in 32% and supplementary stereotactic radiation in 49%. Ninety percent of all patients are in excellent or good health at follow up. These results may be jeopardised by the ongoing proliferation of endovascular treatment for AVMs.

Initial experience with the new ethylene vinyl alcohol copolymer based liquid embolic agent Menox in the endovascular treatment of cerebral arteriovenous malformations

2019 ◽  
Vol 11 (10) ◽  
pp. 1040-1044 ◽  
Author(s):  
Stanimir Sirakov ◽  
Alexander Sirakov ◽  
Krasimir Minkin ◽  
Marin Penkov ◽  
Kristian Ninov ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Vinyl Alcohol ◽  
Arteriovenous Malformations ◽  
Embolic Agent ◽  
Initial Experience ◽  
Cerebral Arteriovenous Malformations ◽  
Ethylene Vinyl Alcohol ◽  
Arteriovenous Shunts ◽  
Liquid Embolic

Background and PurposeLiquid embolic agents (LEAs) are the determinant tool for successful embolization of cranial arteriovenous shunts. There are few currently available LEAs. The aim of the study was to summarize our initial experience with a recently introduced non-adhesive ethylene vinyl alcohol (EVOH) copolymer based LEA (Menox 18) in the endovascular treatment of cerebral arteriovenous malformations.MethodsFrom April 2018 to November 2018, 24 patients harboring cerebral arteriovenous malformations underwent endovascular embolization with Menox 18. Clinical features, angiographic results, procedural details, complications, and follow-up details were prospectively collected and retrospectively analyzed.ResultsCurative embolization in one endovascular session was achieved in 14/24 (58.3%) of the treated patients. Partial embolization was achieved in 10 patients (42.6%) in whom staged treatment with radiosurgery or microsurgical resection was planned. No mortality was recorded in our series. Clinical complications after embolization occurred in 1/24 (4.66%) patients. No technical complications were notedConclusionsOur pilot study suggests that the Menox embolization system offers similar technical and clinical results in comparison with the other currently available LEAs. Further studies with larger cohorts and long term follow-up data are needed to fully evaluate its efficacy

125 Staged Endovascular Treatment of Ruptured Intracranial Aneurysms: Acute Coiling Followed By Delayed Flow Diversion

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 228-228
Author(s):  
Erick Michael Westbroek ◽  
Matthew Bender ◽  
Narlin B Beaty ◽  
Bowen Jiang ◽  
Risheng Xu AB ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Complication Rate ◽  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Major Complication ◽  
Flow Diversion ◽  
Neurological Deficits ◽  
Major Complication Rate ◽  
Ruptured Intracranial Aneurysms

Abstract INTRODUCTION ISAT demonstrated that coiling is effective for aneurysm treatment in subarachnoid hemorrhage (SAH); however, complete occlusion of wide-necked aneurysms frequently requires adjuvants relatively contraindicated in SAH. As such, a limited “dome occlusive” strategy is often pursued in the setting of SAH. We report a single institution series of coiling of acutely ruptured aneurysms followed by delayed flow diversion for definitive, curative occlusion. METHODS A prospectively collected IRB-approved database was screened for patients with aneurysmal SAH who were initially treated by coil embolization followed by planned flow diversion at a single academic medical institution. Peri-procedural outcomes, complications, and angiographic follow-up were analyzed. RESULTS >50 patients underwent both acute coiling followed by delayed, planned flow diversion. Average aneurysm size on initial presentation was 9.5 mm. Common aneurysm locations included Pcomm (36%), Acomm (30%), MCA (10%), ACA (10%), and vertebral (5%). Dome occlusion was achieved in all cases following initial coiling. Second-stage implantation of a flow diverting stent was achieved in 49/50 cases (98%). Follow-up angiography was available for 33/50 patients (66%), with mean follow-up of 11 months. 27 patients (82%) had complete angiographic occlusion at last follow up. All patients with residual filling at follow-up still had dome occlusion. There were no mortalities (0%). Major complication rate for stage I coiling was 2% (1 patient with intra-procedural aneurysm re-rupture causing increase in a previous ICH). Major complication rate for stage 2 flow diversion was 2% (1 patient with ischemic stroke following noncompliance with dual antiplatelet regimen). Minor complications occurred in 2 additional patients (4%) with transient neurological deficits. CONCLUSION Staged endovascular treatment of ruptured intracranial aneurysms with acute dome-occlusive coil embolization followed by delayed flow diversion is a safe and effective treatment strategy.

scholarly journals A proposed grading system for endovascular treatment of cerebral arteriovenous malformations: Buffalo score

2015 ◽  
Vol 6 (1) ◽  
pp. 3 ◽  
Author(s):  
EladI Levy ◽  
TravisM Dumont ◽  
Peter Kan ◽  
KennethV Snyder ◽  
LNelson Hopkins ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Malformations ◽  
Grading System ◽  
Cerebral Arteriovenous Malformations

Endovascular Advances for Brain Arteriovenous Malformations

Neurosurgery ◽  
2014 ◽  
Vol 74 (suppl_1) ◽  
pp. S74-S82 ◽  
Author(s):  
R. Webster Crowley ◽  
Andrew F. Ducruet ◽  
Cameron G. McDougall ◽  
Felipe C. Albuquerque
Keyword(s):  
Endovascular Treatment ◽  
Surgical Resection ◽  
Arteriovenous Malformations ◽  
Treatment Options ◽  
Brain Arteriovenous Malformations ◽  
Short Period ◽  
Cerebral Avms ◽  
Brain Avms ◽  
The Brain ◽  
The Way

Abstract Arteriovenous malformations (AVMs) of the brain represent unique challenges for treating physicians. Although these lesions have traditionally been treated with surgical resection alone, advancements in endovascular and radiosurgical therapies have greatly expanded the treatment options for patients harboring brain AVMs. Perhaps no subspecialty within neurosurgery has seen as many advancements over a relatively short period of time as the endovascular field. A number of these endovascular innovations have been designed primarily for cerebral AVMs, and even those advancements that are not particular to AVMs have resulted in substantial changes to the way cerebral AVMs are treated. These advancements have enabled the embolization of cerebral AVMs to be performed either as a stand-alone treatment, or in conjunction with surgery or radiosurgery. Perhaps nothing has impacted the treatment of brain AVMs as substantially as the development of liquid embolics, most notably Onyx and n-butyl cyanoacrylate. However, of near-equal impact has been the innovations seen in the catheters that help deliver the liquid embolics to the AVMs. These developments include flow-directed catheters, balloon-tipped catheters, detachable-tipped catheters, and distal access catheters. This article aims to review some of the more substantial advancements in the endovascular treatment of brain AVMs and to discuss the literature surrounding the expanding indications for endovascular treatment of these lesions.

scholarly journals Hemorrhagic Complications after Endovascular Treatment of Cerebral Arteriovenous Malformations

2014 ◽  
Vol 35 (5) ◽  
pp. 978-983 ◽  
Author(s):  
H. Baharvahdat ◽  
R. Blanc ◽  
R. Termechi ◽  
S. Pistocchi ◽  
B. Bartolini ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Malformations ◽  
Cerebral Arteriovenous Malformations ◽  
Hemorrhagic Complications

scholarly journals A Technical Note

2013 ◽  
Vol 19 (1) ◽  
pp. 27-34 ◽  
Author(s):  
V.M. Pereira ◽  
A. Marcos-Gonzalez ◽  
I. Radovanovic ◽  
P. Bijlenga ◽  
A.P. Narata ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Young Patient ◽  
Arteriovenous Malformations ◽  
Technical Note ◽  
Cerebral Arteriovenous Malformations ◽  
Arterial Access ◽  
Therapeutic Method ◽  
Endovascular Approach ◽  
Ruptured Avm ◽  
Transvenous Approach

Ruptured cerebral arteriovenous malformations (AVMs) usually require treatment to avoid re-bleeding. Depending on the angioarchitecture and center strategy, the treatment can be surgical, endovascular, radiosurgical or combined methods. The classic endovascular approach is transarterial, but sometimes it is not always applicable. The transvenous approach has been described as an alternative for the endovascular treatment of small AVMs when arterial access or another therapeutic method is not possible. This approach can be considered when the nidus is small and if there is a single draining vein. We present a technical note on a transvenous approach for the treatment of a ruptured AVM in a young patient.

scholarly journals P03.08 Large cerebral arteriovenous malformations management with Volume-staged gamma knife radiosurgery

2019 ◽  
Vol 21 (Supplement_3) ◽  
pp. iii26-iii26
Author(s):  
R M Emad Eldin ◽  
W A Reda ◽  
A M El-Shehaby ◽  
K Abdel Karim ◽  
A Nabeel ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Arteriovenous Malformations ◽  
Gamma Knife Radiosurgery ◽  
Cerebral Arteriovenous Malformations ◽  
Factors Affecting ◽  
Prescription Dose ◽  
The Mean ◽  
Cerebral Avms ◽  
Grade 3

Abstract BACKGROUND Large cerebral arteriovenous malformations (AVM) pose a management dilemma because of the limited success of any single treatment modality by itself. Surgery alone is associated with significant morbidity and mortality. Similarly, embolization alone has limited efficacy. Volume-staged gamma knife radiosurgery (VSGR) has been developed for the treatment of large AVMs, to increase the efficacy and improve safety of treatment of these lesions. The aim of the study was to assess the efficacy and safety of VSGR technique for the treatment of large cerebral AVMs. METHODS The study included patients treated by VSGR between May 2009 and July 2015. All cases had large AVMs (>10 cc). These were 29 patients. RESULTS Twenty-four patients completed radiographic follow up with 15 obliteration cases (62.5%). There was a total of 56 sessions performed. The mean AVM volume was 16 cc (10.1–29.3 cc). The mean prescription dose was 18 Gy (14–22 Gy). The mean follow up duration was 43 months (21–73 months). One patient died during follow up from unrelated cause. Two cases suffered haemorrhage during follow up. Symptomatic edema developed in 5 (17%) patients. The factors affecting obliteration were smaller total volume, higher dose/stage, non-deep location, compact AVM, AVM score less than 3, >18 Gy dose and <15 cc total volume. The factors affecting symptomatic edema were smaller total volume and shorter time between first and last sessions (p 0.012). T2 image changes were affected by SM grade 3 or more (p 0.013) and AVM score 3 or more (p 0.014). CONCLUSION VSGR provides an effective and safe treatment option for large cerebral AVMs. Smaller AVM volume is associated with higher obliteration rate.

scholarly journals Cerebral Arteriovenous Malformations with Associated Arterial Aneurysms: Hemodynamic and Therapeutic Considerations

1988 ◽  
Vol 15 (2) ◽  
pp. 130-134 ◽  
Author(s):  
Douglas Kondziolka ◽  
Bruce J. Nixon ◽  
Pierre Lasjaunias ◽  
Pierre Lasjaunias ◽  
William S. Tucker ◽  
...  
Keyword(s):  
Blood Flow ◽  
Arteriovenous Malformation ◽  
Endovascular Treatment ◽  
Arteriovenous Malformations ◽  
Local Blood Flow ◽  
Cerebral Arteriovenous Malformations ◽  
Regional Hemodynamics ◽  
The Common ◽  
Arterial Aneurysms ◽  
Therapeutic Considerations

ABSTRACT:The common vascular anomalies of cerebral aneurysm and arteriovenous malformation may exist independently, or together as part of a closely related hemodynamic pairing. Resection or embolization of an AVM may be followed by a decrease in local blood flow, and lead to regression of a suitably situated proximal aneurysm. However, aneurysms located outside the angioarchitecture of the AVM, which remain flow-unrelated to the malformation, will likely not regress, and may in fact enlarge. Two cases are presented which demonstrate these vascular relationships, in order to better understand the regional hemodynamics of these anomalies prior to surgical or endovascular treatment planning.

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