Preoperative Embolization of Cerebral Arteriovenous Malformations with Silk Suture and Particles: Technical Considerations and Outcomes
Journal of Cerebrovascular and Endovascular Neurosurgery
;
: 90-99, 2016.
Artigo
em Inglês
| WPRIM
| ID: wpr-144508
ABSTRACT
OBJECTIVE:
Embolization of cerebral arteriovenous malformations (AVMs) is commonly performed prior to surgical resection in order to reduce intraoperative bleeding and improve the safety of resection. Although most modern embolization procedures utilize permanent embolic agents, silk suture and polyvinyl alcohol (PVA) particles may offer unique advantages for preoperative devascularization. The aims of this retrospective cohort study are to describe the technical considerations and determine the outcomes for preoperative silk suture and PVA particle embolization (SPE) of AVMs. MATERIALS ANDMETHODS:
We performed a retrospective review of our AVM embolization database. AVM patients who underwent preoperative SPE and subsequent surgical resection were included for analysis. Baseline patient demographics, AVM characteristics, embolization and operative records, and post-treatment outcomes were reviewed.RESULTS:
A total of 11 patients who underwent 12 preoperative SPE procedures were included for analysis. Five AVMs were ruptured (45%), and the median nidus volume was 3.0 cm3 (range 1.3-42.9 cm³). The Spetzler-Martin grade was I-II in seven patients (64%) and III-IV in four patients (36%). The degree of nidal obliteration was less than 25% in two procedures (17%), 25-50% in one procedure (8%), 50-75% in eight procedures (67%), and greater than 75% in one procedure (8%). The rates of post-embolization AVM hemorrhage and mortality were 8% and 0%, respectively. The postoperative angiographic obliteration rate was 100%, and the modified Rankin Scale score improved or stable in 91% of patients (median follow-up duration 2 months).CONCLUSION:
Preoperative AVM SPE affords a reasonable risk to benefit profile for appropriately selected patients.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Álcool de Polivinil
/
Suturas
/
Malformações Arteriovenosas Intracranianas
/
Demografia
/
Estudos Retrospectivos
/
Estudos de Coortes
/
Seguimentos
/
Mortalidade
/
Acidente Vascular Cerebral
/
Hemorragias Intracranianas
Tipo de estudo:
Estudo de etiologia
/
Estudo de incidência
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Humanos
Idioma:
Inglês
Revista:
Journal of Cerebrovascular and Endovascular Neurosurgery
Ano de publicação:
2016
Tipo de documento:
Artigo
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