Efficacy and safety of endovascular embolization of cerebral AVM

Abstract

Background; Endovascular embolization of cerebral arteriovenous malformations (AVM) has several benifits including AVM occlusion and flow reduction in preparation for other treatment techniques. Aim and objectives; To assess the efficacy and safety of endovascular embolization of cerebral AVM with different techniques and materials. Patients and methods; In a prospective and retrospective study, 22 patients diagnosed as AVM or arteriovenous fistula (AVF) and underwent endovascular embolization at Neurosurgical intervention Unit at Al Hussein University Hospital were recruited in the period from beginning of Jan, 2020 to the end of May, 2022. We included patients aged above one month, diagnosed to have cerebral AVM or AVF. Recent cerebral hemorrhage patients were delayed for at least two weeks. We excluded patients with vein of Galen malformation, neonatal AVM, patients underwent surgical excision, patients with contraindication to radiation or dye injection, and inaccessible endovascular techniques such as severely tortuous vessels. Results: In the current study, the mean age was 24.5 ± 14.7 years. Most cases were male (68.2%). Most cases (86.4% ) manifested headache, 40.9% had hemorrhage, 31.8% had side weakness and 27.3% had fits. Spetzler and Martin grade (SMG) of the cerebral AVMs was significantly improved after embolization compared to the initial grading score (P=0.002). Eight patients showed complete occlusion of nidus and 14 had partial occlusion according to SMG . After 3 months follow up, Modified Rankin scale, epilepsy, and headache were improved. No patient had procedure-related complications.