RT Journal Article
SR Electronic
T1 Endovascular treatment of unruptured and ruptured brain arteriovenous malformations with Onyx18: a monocentric series of 84 patients
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 600
OP 606
DO 10.1136/neurintsurg-2013-010869
VO 6
IS 8
A1 Arturo Consoli
A1 Giulia Scarpini
A1 Andrea Rosi
A1 Leonardo Renieri
A1 Ivano Chiarotti
A1 Chiara Vignoli
A1 Iacopo Ciampa
A1 Sergio Nappini
A1 Nicola Limbucci
A1 Salvatore Mangiafico
YR 2014
UL http://jnis.bmj.com/content/6/8/600.abstract
AB Background Brain arteriovenous malformations (AVMs) are a rare pathology, and their treatment is discussed. The development of techniques and materials in endovascular, radiosurgical, and neurosurgical fields led to higher rates of complete occlusions and good clinical outcomes. Materials and methods 84 patients (52 men, 32 women; mean age 38.2 years; range, 9–70 years) were treated at our institution with Onyx18 from 2001 to 2011. Patients treated with other embolic agents, with micro-AVMs, were not included in the analysis. Results Complete occlusion was achieved in 27/84 patients (32.2%), in 40/84 (47.6%) brain AVMs occlusion of 80–90% of the nidus was obtained, and in 17/84 (20.3%) cases <80% of the nidus was occluded. Intraprocedural adverse events occurred in 11/84 patients (13.1%), and overall mortality and disabling permanent morbidity were 2.3% (2/84) and 4.7% (4/84), respectively. Conclusions Endovascular treatment may be considered a safe and effective approach in superficial small brain AVMs in addition to surgery, mostly in ruptured AVMs. The therapeutic strategy should be to cure small and medium AVMs with endovascular treatment alone or combined treatment. Large unruptured AVMs (Spetzler–Martin grades IV–V) should be treated with target embolization of high flow fistulas or intranidal aneurysms.