Document Detail

Effect of partial targeted N-butyl-cyano-acrylate embolization in brain AVM.
MedLine Citation:
PMID:  12376769     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The management of cerebral arteriovenous malformations needs effective treatments. So far, no study has shown that partial targeted embolization treatment (PTET) reduces the risk of intracranial hemorrhage with respect to the natural history of the malformation. METHODS: The pre-treatment and post-treatment-initialization hemorrhage incidences of neuro-interventional patients were compared. Two hundred fifteen patient years from 519 patients were used to observe the short term course of the untreated disease. Five hundred patient years from 326 patients were used to observe hemorrhage after the start of treatment. The Kaplan-Meier estimator of hemorrhage free time under treatment was compared with results in the literature. Confounding influences resulting from selection processes or the disease parameters were studied. RESULTS: The yearly hemorrhage incidence rate of all untreated patients was observed as 0.089 (95% CI [0.053, 0.138]). This rate was 0.052 (95% CI [0.019, 0.114]) in the subgroup of patients who underwent PTET later. In the same group the observed annual rate after the start of PTET was 0.036 (95% CI [0.021, 0.057]). Crawford's results about intracranial hemorrhage during the natural course show the lowest risk values compared to other published studies [3]. There was a significant difference between the Crawford's reference data and the ICH incidence after the start of PTET in the neuro-interventional population (p=0.037). The morbidity risk in treated patients was 5.3% for a transitory and 2% for a persisting neurological deficit. Mortality results were compared with those of Crawford. CONCLUSION: The neuro-interventional patients under study show a lower hemorrhage risk than the population studied by Crawford. A significant superiority with respect to hemorrhage risk is established two years after the start of the PTET treatment.
H J Meisel; U Mansmann; H Alvarez; G Rodesch; M Brock; P Lasjaunias
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Multicenter Study    
Journal Detail:
Title:  Acta neurochirurgica     Volume:  144     ISSN:  0001-6268     ISO Abbreviation:  Acta Neurochir (Wien)     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-10-11     Completed Date:  2003-02-10     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0151000     Medline TA:  Acta Neurochir (Wien)     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  879-87; discussion 888     Citation Subset:  IM    
Department of Neurosurgery, BG Kliniken Bergmannstrost, Halle, Germany.
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MeSH Terms
Cerebral Hemorrhage / diagnosis,  mortality,  therapy*
Child, Preschool
Embolization, Therapeutic / methods*
Enbucrilate / administration & dosage
Follow-Up Studies
Intracranial Arteriovenous Malformations / diagnosis,  mortality,  therapy*
Middle Aged
Risk Assessment
Survival Rate
Treatment Outcome
Reg. No./Substance:

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