Contribution of interventional neuroradiology in the therapeutic management of brain arteriovenous malformations

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  • Onyx Embolization Before the Surgical Treatment of Grade III Spetzler-Martin Brain Arteriovenous Malformations: Single-Center Experience and Technical Nuances

    2018, World Neurosurgery
    Citation Excerpt :

    Onyx proved to be potentially more useful compared with other widely used embolic agents such as N-butyl cyanoacrylate for decreasing, or even avoiding, the frequency of the NPPB and further hyperemic complications that may follow staged surgical excision of a large high-flow AVM.19,30,39,41 In our experience, the major benefit of the embolization was the occlusion of the deeper arterial feeders, which has been suggested to be the key factor for determining the morbidity and resectability of larger malformations.41,44 It also seemed to facilitate the hemostasis, reducing intraoperative blood loss and making the nidus dissection easier, as has been reported.45

  • Multimodality Treatment of Cerebral Arteriovenous Malformations

    2014, World Neurosurgery
    Citation Excerpt :

    Embolization has been suggested to facilitate other modes of therapy. It may improve surgical outcome by reducing intraoperative blood loss, facilitating hemostasis and nidus dissection (22), eliminating deep feeding arteries (43), and decreasing the frequency of normal perfusion pressure breakthrough hemorrhage when done in a staged fashion (37, 44). We found no significant difference in morbidity in our surgical group compared with our embolization plus surgery group (0% vs. 6% new severe deficits in the surgery alone group vs. the embolization and surgery group), taking into account that the Spetzler-Martin grade was usually higher in the embolization and surgery group.

  • Endovascular treatment of cerebral arteriovenous malformations

    2013, Neuroimaging Clinics of North America
    Citation Excerpt :

    With the widespread application of this agent, obliteration rates may be expected to increase. Vinuela and colleagues39 reported a 9.7% cure rate for the embolization of small AVMs with few feeding pedicles. Gobin and colleagues34 reported a cure rate of 11.2% (14 patients) in a series of 125 patients undergoing preradiosurgical embolization.

  • Endovascular Treatment of Cerebral Arteriovenous Malformations

    2012, Schmidek and Sweet Operative Neurosurgical Techniques: Indications, Methods, and Results: Sixth Edition
  • Cerebral arteriovenous malformations: Issues of the interplay between stereotactic radiosurgery and endovascular surgical therapy

    2011, World Neurosurgery
    Citation Excerpt :

    Endovascular therapy has, therefore, been used both as an adjunct to subsequent radiosurgical targeting of the remaining nidus or as monotherapy to decrease the high-risk load incurred by these features in AVMs. On the other hand, depending on the embolic agent used, curative rates for primary embolization have ranged from 9% to 14% (29, 35, 91, 92), and as high as 84.6% in a recent series of 25 AVMs less than 1 cm in diameter (7). Finally, palliative embolization aims to address the symptoms resulting directly from the existence of and resultant altered cerebral blood from the AVM, such as those due to vascular steal phenomenon or venous hypertension.

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