Endovascular Management of Cerebral Arteriovenous Malformations: Technical and Clinical Outcome

Abstract

Objectives: (1) To report our institutional initial technical experience in the endovascular management of cerebral arteriovenous malformations (AVMs). (2) To detect the clinical outcome involving efficacy and complications of the endovascular management of cerebral AVMs. Methods: This is a cross-sectional study involving 14 cases diagnosed as having cerebral AVMs, who underwent diagnostic angiography and planned after written consent for a attempt of endovascular embolization. Our standard technique will be performed under a general anesthesia and get through transfemoral artery approach Microcatheter will be advanced through a guiding catheter to the arterial feeders supplying the cerebral AVMs. Onyx or Histoacryl was used as embolizing agent for successfully navigated cerebral AVMs by microcatheter Immediate follow-up conventional angiography was done to assess the size of residual AVM. Continuous clinical and radiological follow-up of our cases is still running every 6 months. Results: Technical results involved successful microcatheter navigation and embolization in 9 of 14 cases (64%) with failed microcatheter navigation in 2 of 4 cases (14%) and failed embolization in 3 cases (22%). Clinical results involved controlled recent intracranial hemorrhage on 2 of 3 cases (67%), controlled seizure on 2 of 5 cases (40%), and complicated hemorrhage on 2 of 9 cases (22.2%) with one reported death. Anatomical results more than 50% decreased size of 4 of 9 cases (44.4%) and less than 50% decreased size in 5 of 9 cases (55.5%). Conclusion: Endovascular embolization of cerebral AVMs by transfemoral artery approach using microcatheter navigation and embolization has some technical difficulties with success rate for navigation and embolization (64%). It is an effective treatment method to control hemorrhagic cerebral AVMs, to decrease associated seizures, and to decrease the size of cerebral AVMs. Publication Date: 26 April 2021 (online) © 2020. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India