Abstract
Embolization is widely performed to treat brain arteriovenous malformations, but little has been reported on factors contributing to complications. We retrospectively reviewed a nationwide surveillance to identify risk factors contributing to complications and short-term clinical outcomes in the endovascular treatment of brain arteriovenous malformations. Data for endovascular treatment of brain arteriovenous malformations were extracted from the Japanese nationwide surveillance. Patient characteristics, brain arteriovenous malformation features, procedures, angiographic results, complications, and clinical outcomes at 30 days postprocedure were analyzed. A total of 1042 endovascular procedures (788 patients; mean, 1.43 ± 0.85 procedures per patient) performed in 111 institutions from 2010 to 2014 were reviewed. Liquid materials were used in 976 procedures (93.7%): to perform presurgical embolization in 638 procedures (61.2%), preradiosurgical embolization in 160 (15.4%), and as sole endovascular treatment in 231 (22.2%). Complete or near-complete obliteration of brain arteriovenous malformations was obtained in 386 procedures (37.0%). Procedure-related complications occurred in 136 procedures (13.1%), including hemorrhagic complications in 59 (5.7%) and ischemic complications in 57 (5.5%). Univariate analysis identified deep venous drainage, associated aneurysms, infratentorial location, and preradiosurgical embolization as statistically significant risk factors for complications. Multivariate analysis showed that embolization of brain arteriovenous malformations in the infratentorial location was significantly associated with complications. Patients with complications due to endovascular procedures had worse clinical outcomes 30 days after the procedures than those without complications. Complications arising after endovascular treatment of brain arteriovenous malformations are not negligible even though they may play a role in adjunctive therapy, especially in the management of infratentorial brain arteriovenous malformations.
Highlights
BACKGROUND AND PURPOSEEmbolization is widely performed to treat brain arteriovenous malformations, but little has been reported on factors contributing to complications
Multivariate analysis showed that embolization of brain arteriovenous malformations in the infratentorial location was significantly associated with complications
Complications arising after endovascular treatment of brain arteriovenous malformations are not negligible even though they may play a role in adjunctive therapy, especially in the management of infratentorial brain arteriovenous malformations
Summary
Data for endovascular treatment of brain arteriovenous malformations were extracted from the Japanese nationwide surveillance. Brain arteriovenous malformation features, procedures, angiographic results, complications, and clinical outcomes at 30 days postprocedure were analyzed. The Japanese Registry of Neuroendovascular Therapy (JR-NET) is a nationwide retrospective registration study. Clinical and procedural data were enrolled through a Web site constructed by the Translation Research Informatics Center (Kobe, Japan) and anonymously reviewed by the principal investigators. The institutional review board at Kobe City Medical Center General Hospital approved the study protocol of JR-NET. Previous studies have been reported on data from JR-NET1 and JR-NET2, which were conducted from 2005 to 2006 and 2007 to 2009, respectively.[13,14] A total of 40,169 endovascular procedures were reviewed in the JR-NET3 study from 2010 to 2014, including 1063 procedures (2.7% of all procedures) for bAVMs treated by embolization. After excluding incomplete or duplicate data, we analyzed 1042 procedures performed for bAVMs for which detailed data were available
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
