Document Detail

Embolisation of Small (< 3 cm) Brain Arteriovenous Malformations. Correlation of Angiographic Results to a Proposed Angioarchitecture Grading System.
MedLine Citation:
PMID:  20663327     Owner:  NLM     Status:  PubMed-not-MEDLINE    
The role of embolisation in the treatment of small < 3cm) brain arteriovenous malformations (AVMs) has not been elucidated. We reviewed our experience using embolisation in the treatment of small AVMs and correlated a proposed grading system based on the angioarchitecture to the percentage obliteration achieved by embolisation. Eighty-one small AVMs in 80 patients were embolised from 1984 to 1999. The age range was from 3 to 72 years. The AVMs were given a score from 0 to 6 based on the angioarchitecture. The assigned scores were as follows: nidus (fistula = 0, < 1 cm = 1, 1-3 cm = 2), type offeeding arteries (cortical = 0, perforator or choroidal = 1), number of feeding arteries (single = 0, multiple = 2) and number of draining veins (single = 0, multiple = 1). Angiographic results based on percentage obliteration were grouped into three categories: complete, 66-99%, and 0-65%. The goal of embolisation was cure in 27 AVMs, pre-surgical in 23, pre-radiosurgery in 26, and elimination of an aneurysm in five. Embolisation achieved complete obliteration in 22 (27%) of the 81 AVMs. In the AVMs where the goal was cure, 19 (70%) of 27 were completely obliterated. In the AVMs with angioarchitecture scores of 0-2, 12 (86%) of 14 were cured, with scores of 3-4, 8 (34%) of 24 were cured and with scores of 5-6, 2 (4%) of 44 were cured. Embolisation resulted in transient morbidity of 5.0%, permanent morbidity of 2.5%, and mortality of 1.2%. There were no complications in AVMs with scores of 0-2. Embolisation is an effective treatment of small AVMs when the angioarchitecture is favourable (scores 0-2). This includes pure fistulas and AVMs with a single, pial, feeding artery.
R Willinsky; M Goyal; K Terbrugge; W Montanera; M C Wallace; M Tymianski
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Publication Detail:
Type:  Journal Article     Date:  2001-05-15
Journal Detail:
Title:  Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences     Volume:  7     ISSN:  1591-0199     ISO Abbreviation:  Interv Neuroradiol     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2010-07-28     Completed Date:  2012-10-02     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  9602695     Medline TA:  Interv Neuroradiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  19-27     Citation Subset:  -    
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