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Research ArticleInterventional

Combined Treatment of Brain AVMs with Use of Onyx Embolization followed by Radiosurgery

L. Pierot, K. Kadziolka, F. Litré and P. Rousseaux
American Journal of Neuroradiology July 2013, 34 (7) 1395-1400; DOI: https://doi.org/10.3174/ajnr.A3409
L. Pierot
aFrom the Departments of Neuroradiology (L.P., K.K.)
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K. Kadziolka
aFrom the Departments of Neuroradiology (L.P., K.K.)
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F. Litré
bNeurosurgery (F.L., P.R.), Hôpital Maison-Blanche, CHU Reims, Reims, France.
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P. Rousseaux
bNeurosurgery (F.L., P.R.), Hôpital Maison-Blanche, CHU Reims, Reims, France.
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Article Figures & Data

Figures

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  • Fig 1.
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    Fig 1.

    Left frontal AVM. A, Left internal carotid angiogram (lateral view) shows the AVM before treatment. B, Onyx cast after the first embolization session. C, Left internal carotid angiogram (lateral view) shows the AVM after the first embolization session. D, Onyx cast after the second embolization session. E, Left internal carotid angiogram (lateral view) shows the AVM after the second embolization session. F, Onyx cast after the third embolization session. G, Left internal carotid angiogram (lateral view) shows the AVM after the third embolization session. H, Onyx cast after the fourth embolization session. I, Left internal carotid angiogram (lateral view) shows the AVM after the fourth embolization session. J, Onyx cast after the fifth embolization session. K, Left internal carotid angiogram (lateral view) shows the AVM after the fifth embolization session. L, Left internal carotid angiogram (lateral view) shows complete cure of the AVM at 5 years after radiosurgery.

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    Fig 2.

    Right frontal AVM. A, Right internal carotid angiogram (lateral view) shows the AVM before treatment. B, Right internal carotid angiogram, noninjected and unsubstracted (lateral view), shows the Onyx cast after 5 embolization sessions and before radiosurgery. C, Right internal carotid angiogram shows the residual nidus before radiosurgery. D, Right internal carotid angiogram shows a residual nidus 4 years after radiosurgery.

Tables

  • Figures
  • Patient and AVM characteristics, treatment data, and anatomic outcome

    Pt No.Sex/AgePresentationAVMEmbolizationRadiosurgeryOutcome
    SM Grade (I–IV)Size (cm)LocationSessions (n)Onyx Volume (mL)Delay* (month)Volume Radiated (mL)
    1M/35HemorrhageI1.1 × 0.7Parietal10.2560.6CO
    2F/45AsymptomaticI1.2 × 0.8Temporal10.45120.5CO
    3F/55HemorrhageI1.3 × 1.2Frontal11.0160.6RN
    4M/28HemorrhageII2.5 × 2.0Frontal40.6581.2CO
    5F/15AsymptomaticII2.0 × 1.2Temporal42.65360.9Ongoing
    6F/12SM deficitII2.0 × 1.3Frontal23.283.0Ongoing
    7M/42HemianopsiaII2.0 × 1.0Frontal33.3560.9CO
    8M/50AsymptomaticII3.8 × 2.7Temporal55.072.9RN
    9M/28EpilepsyII4.2 × 2.5Frontal78.7565.2Ongoing
    10F/10EpilepsyII3.2 × 1.5Frontal52.4571.1CO
    11F/39Motor deficitIII3.3 × 1.7Frontal21.757.8CO
    12M/29EpilepsyIII3.9 × 2.7Frontal54.4563.2RN
    13F/26EpilepsyIII3.1 × 2.0Frontal55.9580.7RN
    14M/41HemorrhageIII3.7 × 1.1Corpus callosum54.586.7CO
    15M/25EpilepsyIII3.9 × 2.5Temporal812.884.9RN
    16F/45HemorrhageIV3.4 × 1.9Temporal33.5125.5CO
    17M/23HemorrhageIV4.0 × 2.4Frontal35.267.9RN
    18F/37EpilepsyIV4.1 × 1.9Frontal56.565.3CO
    19F/31HemorrhageIV3.2 × 2.3Thalamus43.312.9RN
    20F/49HemorrhageIV3.9 × 2.8Frontal412.3312.1CO
    • Note:—F indicates female; M, male; SM Spetzler-Martin grade; CO, complete occlusion; RN, residual nidus.

    • ↵* Delay between embolization and radiosurgery.

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American Journal of Neuroradiology: 34 (7)
American Journal of Neuroradiology
Vol. 34, Issue 7
1 Jul 2013
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Combined Treatment of Brain AVMs with Use of Onyx Embolization followed by Radiosurgery
L. Pierot, K. Kadziolka, F. Litré, P. Rousseaux
American Journal of Neuroradiology Jul 2013, 34 (7) 1395-1400; DOI: 10.3174/ajnr.A3409

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Combined Treatment of Brain AVMs with Use of Onyx Embolization followed by Radiosurgery
L. Pierot, K. Kadziolka, F. Litré, P. Rousseaux
American Journal of Neuroradiology Jul 2013, 34 (7) 1395-1400; DOI: 10.3174/ajnr.A3409
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  • Value of 4D MR Angiography at 3T Compared with DSA for the Follow-Up of Treated Brain Arteriovenous Malformation
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