Endovascular transvenous cure for ruptured brain arteriovenous malformations in complex cases with high Spetzler-Martin grades

Journal of Neurosurgery
Christina IosifC Mounayer

Abstract

Ruptured cerebral arteriovenous malformations (AVMs) with deep localization and high Spetzler-Martin grades are associated with considerable challenges regarding nidus eradication treatment. The authors report their experience with curative endovascular transvenous embolization in a series of patients harboring "untreatable" lesions. Between January 2008 and June 2013, a transvenous endovascular embolization protocol was implemented at the authors' institution for consecutive patients with ruptured brain AVMs that were considered incurable by classic endovascular and surgical techniques. Therapeutic decision making was based on Spetzler-Martin grades, AVM location, type of venous drainage, and angioarchitectural evaluation. Complete exclusion of the nidus was the objective of treatment. Twenty patients (10 male and 10 female, mean age 36.7 ± 17.7 years) were included. Initial Spetzler-Martin grades were III-V for 90.0% of the patients. The lesions were deeply seated in 80% and in eloquent locations in 90% of cases. The preprocedural modified Rankin Scale score was 0-2 for 12 of the 20 patients (60.0%), 3 for 2 patients (10.0%), and 4 for 6 patients (30.0%). The postprocedural clinical status was unchanged for all patients. The ...Continue Reading

References

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Citations

Jul 5, 2017·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Xianli LvYouxiang Li
Jun 11, 2017·Journal of Neurointerventional Surgery·Dinark Conceição VianaDaniel Giansante Abud
Apr 3, 2019·JAMA : the Journal of the American Medical Association·Bradley A GrossRobert M Friedlander
Jul 28, 2018·Journal of Neurosurgery·Hengwei JinIvan Radovanovic
Mar 9, 2019·Journal of Neurosurgery·Peyton L NissonMichael T Lawton
Feb 16, 2018·Journal of Neurosurgical Sciences·Yi-Bin FangWaleed Brinjikji
Oct 13, 2017·Journal of Neurointerventional Surgery·Raphaël BlancMichel Piotin
Jul 14, 2019·Journal of Neurointerventional Surgery·Arthur WangPhilip M Meyers
Dec 22, 2019·Journal of Neurointerventional Surgery·Bledi C BrahimajDemetrius Klee Lopes
May 8, 2018·Neurosurgical Review·Ali Tayebi Meybodi, Michael T Lawton
Mar 8, 2019·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Robert FahedJean Raymond
May 12, 2019·Neurosurgery·Dale DingJason P Sheehan
Mar 14, 2020·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Melissa A LoPrestiSandi Lam
Nov 11, 2020·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Melissa A LoPresti, Sandi Lam
Sep 18, 2020·Cardiology in Review·Fawaz Al-MuftiChirag D Gandhi
Mar 5, 2021·The Neuroradiology Journal·Mohammad GhorbaniAbolghasem Mortazavi
Apr 20, 2021·The International Journal of Neuroscience·Ismail KayaNurullah Yuceer

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