Endovascular Embolization of Cerebral Arteriovenous Malformations: Results of the Japanese Registry of Neuroendovascular Therapy (JR-NET) 1 and 2

Abstract

This retrospective study constitutes a part of the Japanese Registry of Neuroendovascular Therapy (JR-NET) 1 and 2. Its purpose is to evaluate the feasibility, safety, and outcome of endovascular embolization for cerebral arteriovenous malformations (AVMs) in Japan. Nine hundred and eighty-seven embolization procedures were registered with JR-NET 1 and 2 (424 procedures in 122 institutions with JRNET 1 and 563 procedures in 150 institutions with JRNET 2). In total, 790 patients (80.1%) had favourable clinical outcomes defined as modified Rankin Scale (mRS) scores 0–2 at 30 days after embolization. Complete AVM obliteration by embolization alone was achieved in 90 procedures (9.1%). The procedural morbidity and mortality rate was 2.5% and 0.3% per procedure, respectively. In the multivariate logistic regression models, deep venous drainage and embolization of four or more feeding pedicles per session were significantly associated with any treatment-related complications (P = 0.02 and P = 0.003, respectively). About 6 cm or more in maximum nidus diameter had a negative correlation with complications (P = 0.003). Our study shows that embolization of cerebral AVMs was performed with a high degree of safety and a low rate of symptomatic complications in Japan.