Angioarchitecture features of cerebral arteriovenous malformation and embolization treatment with Onyx

Abstract

Objective To explore the vascular architecture features of cerebral arteriovenous malformations (AVMs) and discuss the application of Onyx for endovascular embolization. Methods Twenty-six patients with cerebral AVMs treated in our department from March 2005 to December 2006 were enrolled in this study. Based on the angioarchitecture features of the AVMs in the hindbrain identified by cerebral angiography and ultraselective angiography, Onyx was used to for endovascular embolizations of the AVMs. Results Prior to embolization of the AVMs with Onyx, the segmentation, number of the draining veins, presence of open drainage, feeding pattern and structures associated with aneurysms were analyzed. Priority of embolization was given to the AVMs complicated by aneurysms and the thick feeding arteries at low risk. In these patients, 7 (26.9%) showed completely resolved AVMs, 10 (38.5%) had vascular mass reduction by more than 90%, 7 (26.9%) had reduction by 70%-90%, and 2 (7.7%) had reduction by less than 70%. Conclusion A comprehensive cerebral angiography may help in effective embolization of the AVMs with Onyx, and the embolization effect can be enhanced with skillful injection techniques. Key words: Cerebral arteriovenous malformations; Vascular architecture features; Endovascular therapy