Article Text
Abstract
Purpose The intracranial hemorrhage is the most important complication during or after embolization of brain arteriovenous malformations (AVM). This study was designed to identify the possible risk factors related to intracranial bleeding during and after embolization of brain AVMs.
Material and Methods The 474 consecutive embolization procedures of AVMs, performed in Neurointerventional service of Rothschild Foundation, Paris, France, were studied retrospectively .The clinical and morphological characteristics of them were reviewed and analyzed.
Results The mean age of patients was 32.2 years±13.8 (SD). The AVMs were located cortically in 70%, deep in 20%, and infratentorial in 10%. The most common clinical presentations were hemorrhage in 46% of cases and seizure in 23%. The procedural complications were intracranial bleeding (12%), catheter-related problems (10%), and ischemia (3.7%). The Onyx volume injected in procedures with hemorrhagic complications was more than the ones without hemorrhagic complications (p=0.020). The intracranial bleeding was not related to the patients' age (p=0.2), nidus size (p=0.59), hemorrhagic presentation of AVM (p=0.54), the spetzler-Martin grade of AVM (p=0.75), and location of AVM (deep-infratentorial vs cortical, p=0.28). The hemorrhagic complication was not different between the procedures used detachable microcatheter and the procedures used nondetachable microcatheter (p=0.61).
Conclusions According to results of this study, in neuroendovascular treatment of AVMs, the onyx volume injected during the procedure can affect the development of intracranial bleeding.