Role of Endovascular Treatment in the Management of Intracranial Arteriovenous Malformations: Experience of 15 Cases

ABSTRACT

The authors report the results of treatment in 15 patients with intracranial arteriovenous malformations(AVM's) who underwent embolization with n-butyl cyanoacrylate(NBCA) and poly vinyl alcohol(PVA) particle between March, 1990 and August, 1992 at Seoul National University Hospital and discuss about role of endovascular treatment in the management of intracranial AVM's. Seven patients(46.7%) had pre-operative embolization, microsurgery was done in six patients and radiosurgery was done in one patient. In patients with pre-operative embolization, endovascular treatment had helped microsurgery in dissection, diminution of blood transfusion, and shorter time of surgery. AVM's of two patients(12.5%) were totally occluded by embolization alone. But they had morbidity after embolization due to inadvertent occlusion. AVM's of six patients(40%) were partially occluded and recurrence of previous symptoms, bleeding, revascularization, increase of AVM nidus developed during follow up. It is concluded that role of endovascular treatment is in intracranial AVM's adjuvant, definite, palliative. Except surgical resection after embolization, embolization alone should be done very cautiously indefinite and palliative treatment.