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

World Neurosurgery
Sabino LuzziRenato J Galzio

Abstract

Grade III Spetzler-Martin brain arteriovenous malformations (AVMs) are a specific set of AVMs with high variability in terms of site, size, angioarchitecture, flow dynamics, and involvement of eloquent areas. Surgery preceded by preoperative embolization has been reported as a useful treatment option for these lesions. The aim of this study is to report outcomes and personal experience of combined preoperative Onyx embolization and surgical resection on a consecutive series of grade III brain AVMs. Between 2005 and 2017, 27 grade III AVMs were treated by means of a staged Onyx embolization and subsequent surgical treatment. Site and size of the AVMs, embolization, and surgical specifics as well as complications and outcomes were retrospectively reviewed. All AVMs were supratentorial, 13 of which were hemorrhagic. Mean nidal volume was 19.5 mL. Average embolization sessions were 1.6. Mean embolization-related obliteration rate and morbidity were 28.8% and 3.7%, respectively. Surgery was performed within 3.7 days on average. In our experience, Onyx embolization made the nidus excision easier, facilitated the hemostasis, and contributed to the early identification of the lesion in cases of small or racemose nidus. The surgical obl...Continue Reading

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Citations

Aug 20, 2020·Journal of Materials Chemistry. B, Materials for Biology and Medicine·Jasmine LordAndrew L Lewis
Apr 30, 2020·Medicina·Gabriele SavioliMaria Antonietta Bressan
Sep 30, 2020·Journal of Neurointerventional Surgery·Humain BaharvahdatMichel Piotin
Sep 18, 2020·Cardiology in Review·Fawaz Al-MuftiChirag D Gandhi
Jun 24, 2020·Neuro-Chirurgie·M D N SantinH Cebula
Jul 17, 2020·Heliyon·Gabriele SavioliMaria Antonietta Bressan
Dec 8, 2019·Journal of Neurosurgery·Sabino LuzziRenato Galzio

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