Risk factors and interventional therapy of hemorrhage in brain arteriovenous malformation associated with aneurysm / 中国介入影像与治疗学

ABSTRACT

Objective To explore the risk factors and interventional strategies of bleeding caused by brain arteriovenous malformations associated with aneurysms.Methods Clinical and imaging data of 42 cases of brain arteriovenous malformations associated with aneurysms were collected and analyzed.According to the results of intraoperative angiography and the architectural characteristics of vessels,the therapeutic schedule was formulated.Three months,6 months and 1 year after interventional management,all patients were followed with DSA to observe whether arteriovenous malformations recurred or not.Results The risk factors of hemorrhage caused by brain arteriovenous malformations associated with aneurysms included lesions located in subtentorium,deep vein or mixed venous drainage,Spetzler-Martin grade Ⅲ-Ⅳ,as well as type Ⅰ and type Ⅱ a aneurysms of Redekop classification.Glasgow outcome score of 38 postoperative patients were more than 4 points,visual impaired happened in 1 patient,whereas 2 patients had different degree of limb dysfunction and 1 patient died.DSA follow-up found no recurrence of arteriovenous malformation in 37 patients.Conclusion Understanding the vessel architectural characteristics and substantial hemorrhage risk factors before intervention,therefore formulating individualized therapeutic schedules are benefit to improving safety and efficacy for the treatment of brain arteriovenous malformations associated with aneurysms.