Palliatively treated cerebral arteriovenous malformations: follow-up results

Abstract

The purpose of this study was to evaluate the benefits of palliative embolisation of patients with inoperable intracranial AVMs. It involved the analysis of the long-term clinical follow-up results of 27 patients with inoperable intracranial AVMs. Sixteen patients were treated medically and 11 patients received partial embolisation. The mean size of the lesions was 7.2 ± 2.6 cm, and the mean follow-up period was 99 ± 44 months (range 52–192 months). There were no significant statistical differences in the sex, age, size, venous drainage pattern, location of the lesions or presented symptoms. The analysis of the long-term clinical follow-up results showed no significant difference in either the risk of haemorrhage or clinical status of the patients in the two treatment groups. Of the 16 patients in the medical treatment group, 8 (50%) showed a clinical improvement, 3 no improvement and 5 (31%) deterioration. Of the 11 patients in the embolisation group, 5 (45.5%) showed clinical improvement, 3 no improvement and 3 (27.3%) deterioration (P = 0.871). Twenty-five percent (4 cases) of patients in the medical group and 45.5% (5 cases) of patients in the embolisation group suffered from haemorrhage during the follow-up period (P = 0.270). Complications related to embolisation occurred in three cases. This comparative study shows that palliative partial embolisation of intracranial AVMs, in all probability does not produce better clinical results than medical treatment.