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Successful Transvenous Embolization of Brain Arteriovenous Malformations using Onyx in Five Consecutive Patients.
MedLine Citation:
PMID:  21346657     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: There is an increasing application of endovascular treatment for brain arteriovenous malformations (BAVMs) using ethylene-vinyl alcohol co-polymer (Onyx). Historically, this treatment has been performed using a transarterial approach. OBJECTIVE:: To report our experience with transvenous endovascular embolization with Onyx (TVEO). METHODS:: Five consecutive patients with BAVMs underwent endovascular TVEO between June 2007 and March 2009 in the Interventional Neuroradiology Department of the University Hospital of Limoges. There were three males and two females with a mean age of 41.8 years (range, 19-57 years). The clinical presentation included symptoms due to intracerebral hemorrhage (n = 4) and seizures (n = 1). According to the Martin-Spetzler classification scheme, three BAVMs (60%) were grade III, and two BAVMs (40%) were grade IV. Four BAVMs (80%) were supratentorial and one BAVM (20%) was infratentorial. Immediate and mid-term treatment (six months) outcomes were angiographically and clinically analyzed according to the modified Rankin Scale (mRS). RESULTS:: The transvenous approach was achieved in all patients (100%). The success rate of complete obliteration of the AVM nidus was 80% (four of five), confirmed by follow-up angiography performed immediately, and at six months after, TVEO. No procedure-related complications occurred during or after embolization. All patients remained unchanged (mRS score=0-2) and clinically stable six months after TVEO. CONCLUSION:: Use of the transvenous approach using Onyx for the management of BAVMs is shown to be an efficient and safe alternative treatment in cases with no other conventional therapeutic choice and when some anatomical considerations are respected.
Authors:
Iruena Kessler; Roberto Riva; Maria Ruggiero; Monica Manisor; Maher Al-Khawaldeh; Charbel Mounayer
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-22
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Department of Interventional Neuroradiology, University of Brasília, Brasília, Brazil; 2Department of Interventional Neuroradiology, CHU Dupuytren, Limoges, France; 3Servizio di Neuroradiologia, Ospedale Umberto I - Torrette, Ancona, Italy.
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