Quantitative assessment of changes in cerebral arteriovenous malformation hemodynamics after embolization

Stroke; a Journal of Cerebral Circulation
Ali AlarajFady T Charbel

Abstract

Embolization reduces flow in arteriovenous malformations (AVMs) before surgical resection, but achievement of this goal is determined subjectively from angiograms. Here, we quantify effects of embolization on AVM flow. Records of patients who underwent AVM embolization at our institution between 2007 and 2013 and had flow rates obtained pre- and postembolization using quantitative magnetic resonance angiography were retrospectively reviewed. Total flow was estimated as aggregate flow within primary arterial feeders or flow in single draining veins. Twenty-one patients were included (mean age 35 years, 24% hemorrhagic presentation) with Spetzler-Martin grades 1 to 4. Fifty-four total embolization sessions were performed. The mean AVM flow was 403.4±262.4 mL/min at baseline, 285.3±246.4 mL/min after single session (29% drop, P<0.001), and 102.0±103.3 mL/min after all sessions of embolization (75% drop, P<0.001). Total number of pedicles embolized (P<0.001) and embolization of an intranidal fistula during any session (P=0.002) were significantly associated with total decreased flow postembolization. On multivariate analysis, total pedicles embolized was predictive of total flow drop (P<0.001). However, pedicles embolized per sessi...Continue Reading

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Citations

Mar 6, 2016·Clinical Radiology·M MarklC K Rigsby
Dec 23, 2015·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Sophia F ShakurAli Alaraj
Aug 3, 2017·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Rodrigo RiveraCatalina Merino-Osorio
May 31, 2017·Acta neurochirurgica·Michael Kerin MorganMarcus Andrew Stoodley
Oct 16, 2018·Ultraschall in der Medizin : Organ der Deutschen Gesellschaft für Ultraschall in der Medizin, [der] Österreichischen Gesellschaft für Ultraschall in der Medizin, [der] Schweizerischen Gesellschaft für Ultraschall in Medizin und Biologie·Imane El SanharawiPhilippe Bonnin
Aug 21, 2021·Frontiers in Physiology·Matthias BarralPhilippe Bonnin
Oct 9, 2021·AJNR. American Journal of Neuroradiology·Y TakedaN Saito
Dec 8, 2021·Journal of Neurointerventional Surgery·Zhipeng LiYuanli Zhao

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