Staged embolization of large brain arteriovenous malformation: clinical and angiographic results

Abstract

Objective To investigate the complications and follow - up results of staged embolization therapy on patients with large brain arteriovenous malformations ( AVM ) and to evaluate the efficacy of this technique.Methods Twenty -three patients with large AVMs (diameter≥6 cm) were embolized individually for several sessions,with more than one month intervals between embolization stages.Eight patients were treated by γ-knife after the embolization.Twenty - two of them experienced clinical and angiographic follow - up.Results Complete nidus obliteration was found in 14 patients after embolization.Three patients suffered from cerebral hemorrhage in the whole embolization therapy sequence,and 4 from cerebral infarction.At follow- up after the whole treatment sequence,19 cases were completely obliterated,20 had better clinical results,2 had worse results and 1 patient died.Conclusions The patient with large brain AVM could be cured by staged embolization.Stereotactic radiosurgery is an effective assistant therapy for large AVMs. Key words: Intracranial arteriovenous malformations ; Large; Staged embolization; Onyx