Introduction Transvenous approach (TVA) has been attracted increasing attention as an alternative technique for embolization of brain arteriovenous malformations (AVMs). TVA is used in the complicated cases, which are high-risk or not available for another treatment options. We dicribe our expierence of TVE treatment of 61 patient with cerebral AVM.
Materials and methods Between 2011 and 2017 in the center of angioneurology and neurosurgery academican E.N. Mechalkin national medical research center 61 patients were treated using TVA. 61 patients were completely treated, ranging in age from 11 to 69. The Spetzler-Ponce grades were as follows: A for 30 patients (49.2%), B for 30 patients (49.2%) and C for 1 patient (1.6%). According to mRS before the treatment 46 patients (75.4%) had ‘0’, 10 (16.4%) – ‘1’, 2 (3.3%) – ‘2’, 1 (1.6%) – ‘3’ and 2 (3.3%) – ‘4’. 25 patients (41%) had been treated with transarterial approach (1 to 5 sessions) before the final transvenous session.
Results and discussions The complete obliteration of TVA was achieved in 88.9% of the cases. 7 patients with partial obliteration was consequently successfully treated using radiosurgery or microsurgery following to embolization There were 25 procedure-related complications (8 ischemic and 17 hemorrhagic), which included morbidity rate of 4.9% and mortality rate of 4.9%.
Conclusion The results showed that transvenous approach is reliable, effective and safe technique for treatment of patients with brain AVMs in selected cases, and provided additional option for neurosurgeons. Further investigation of TVA will allow to expand the spectrum of its application and to create precise protocols for endovascular management of brain AVMs.
Disclosures M. Demyanovskaya: None. N. Strelnikov: None. A. Alshevskaya: None. K. Orlov: None.
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