Treatment of cerebral arteriovenous malformations by neuroradiological intervention and surgical resection

Acta neurochirurgica
M WestphalH D Herrmann

Abstract

We present the results of a series of 105 patients with cerebral arteriovenous malformations (AVMs) who were treated by a combined protocol including endovascular occlusive measures and open surgical resection. 25 patients were treated only by surgical intervention, 72 patients underwent preoperative endovascular embolization and 8 patients were treated only by embolization, seven of which were only treated for palliation. After superselective angiography the vascular territories suitable for endovascular or microsurgical approach were defined, and in most cases these territories were complementary to each other. In 56 cases, only one embolization was necessary and due to an advantageous co-localization of the departments the whole combined endovascular/neurosurgical procedure was done in one anesthesia. If several endovascular sessions were necessary (16 patients), the resection was mostly carried out immediately after the last neuroradiological session in the same anesthesia with total time of such combined procedure now averaging about 7 hours. According to the proposed grading system by Spetzler we treated 25 grade 1, 24 grade 2, 40 grade 3, 11 grade 4, and 5 grade 5 lesions. The overall success rate defined as complete res...Continue Reading

References

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Citations

Jul 29, 2009·Klinische Neuroradiologie·Ulrich Grzyska, Jens Fiehler
Sep 15, 1998·Surgical Neurology·R DerutyF Turjman
Jul 22, 2008·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·H OkuderaT Takizawa

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