Brain arteriovenous malformation treatment with transvenous endovascular technique after transarterial technique failure

Daniel Buzaglo Gonçalves ,Vitória Miki Pang Takatani,Moisés Buzaglo Salles,Gabriela Campos Da Silva Coutinho,Massanobu Takatani,Louise Makarem Oliveira,Lucas De Cristo Rojas Cabral,Carlos Michel Albuquerque Peres ,Maria Izabel Andrade Dos Santos ,Robson Luís Oliveira De Amorim

doi:10.52600/2763-583x.bjcr.2021.1.2.53-58

Daniel Buzaglo Gonçalves , Vitória Miki Pang Takatani + Show 8 more

Open Access

https://doi.org/10.52600/2763-583x.bjcr.2021.1.2.53-58

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Abstract

Arteriovenous malformations (AVMs) are unnatural connections in the vascular system. The treatment strategies are dictated by the angioarchitecture, location and presentation of AVMs. The present study sought to report a case report of a 35-year-old female patient diagnosed with a brain AVM and submitted to a transvenous AVM embolization, located at the corpus callosum's splenium, after a previous transarterial embolization failure. As a therapeutic approach, the patient was submitted to transarterial embolization. However, the procedure was performed too proximally in the arteries, which resulted in the total AVM persistency. The patient was submitted to angiographic control until complete AVM occlusion.

Highlights

Arteriovenous malformations (AVMs) are unnatural connections in the vascular system
The present study sought to report a case report of a 35-yearold female patient diagnosed with a brain AVM and submitted to a transvenous AVM embolization, located at the corpus callosum's splenium, after a previous transarterial embolization failure
The patient was submitted to transarterial embolization

Summary

Introduction

Arteriovenous malformations (AVMs) are unnatural connections in the vascular system. Epidemiological studies showed that the incidence of AVMs ranges from 1.12 to 1.42 cases per 100.000 individuals per year, with 38– 68% of new cases presenting as firstever hemorrhage. Surgical approach is usually performed from transarterial access, with arterial feeders disconnection followed by the draining vein ligation [8,9]. The transvenous access risks and benefits are still to be properly established due to a small number of reported cases, according to Chen and colleagues [7] The purpose of this study was to present a case report of a patient submitted to a transvenous AVM embolization after a previous transarterial embolization failure. A 35-year-old female patient was diagnosed with a brain AVM, located at the corpus callosum's splenium. Magnetic resonance imaging revealed intracranial hemorrhage (Figure 1), and a cerebral angiography was performed to evaluate the AVM. The present AVM was located in the region between the right lateral ventricle posterior horn projection and the corpus callosum's splenium.

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Conclusion