Possibility of thromboaspiration method in treatment of embolic migration complication during arteriovenous malformation embolization of the head and neck localization.

Abstract

Aim: To analyze the embolic migration complication during arteriovenous malformations (AVMs) embolization of the head and neck localization, and to demonstrate the possibility of tromboaspiration method in treatment of such complications in cerebrovascular region. Materials and Methods: The endovascular intervention was performed in 116 patients with AVMs of the head and neck localization. We used a superselective catheterization of the external cerebral artery branches as a treatment method of AVMs embolization. During embolization of AVMs, the spherical and not spherical polyvinyl alcohol (PVA) emboli were implanted. Results: The result of treatment was technically successful in 112 (96,6 %) patients with AVMs of the head and neck localization. There were 4 (3,5 %) cerebrovascular complications during AVMs embolization of the head and neck localization. In 2 cases a cerebrovascular complication arose during the AVMs embolization of head localizations. In those 2 cases the cerebrovascular complications were successfully treated conservatively. In other 2 cases cerebrovascular complications arose during the AVMs embolization of neck localizations. One patient died as result of a massive ischemic stroke in the vertebrobasilar zone. Another patient was successful treated by tromboaspiration method. Conclusions: Any surgical intervention on the carotid arteries, including endovascular surgery, is associated with a risk to the health and life of the patient. A thorough angiographic diagnosis of the external and internal carotid and vertebral arteries is necessary before endovascular embolization. Modern endovascular technology, such as tromboaspiration, may be helpful to avoid embolic migration complication in cerebrovascular region.