Transarterial Embolisation of Cerebral Arteriovenous Malformations

Wikholm, Gunnar; Lundqvist, Christer; Svendsen, P.

doi:10.1177/159101999700300203

Cited by 12 publications

(28 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Currently, cAVMs are usually treated with embolization followed by surgery or complementary obliteration with radiosurgery 8 . According to Spetzler and Martin, preoperative embolization of small and superficial cAVMs located in surgically accessible noneloquent locations brings little benefit 21 .…”

Section: Discussionmentioning

confidence: 99%

“…The main goal of treatment in cAVM is the prevention of hemorrhage, although it is also indicated in the presence of seizures and progressive neurological deficit 8,9 . The factors that are known to predispose to the occurrence of hemorrhage are smallsized lesions, deep or posterior fossa location, deep venous drainage, venous stenosis, elevated per-fusion pressure, and presence of aneurysms 2,3,[10][11][12][13] .…”

mentioning

confidence: 99%

“…Some investigators claim that presentation with seizures may be a protective factor against hemorrhage in untreated cAVMs. 1,3,14 Hemorrhage can only be prevented by total obliteration or excision of the lesion, since residual pathologic vessels may cause bleeding 8,15 . Several studies have also reported that embolization in cAVM may be useful in the management of patients presenting hard-to-control seizures, progressive neurological deficit, and headaches, and to improve cerebral perfusion 8,9,16 .…”

mentioning

confidence: 99%

“…1,3,14 Hemorrhage can only be prevented by total obliteration or excision of the lesion, since residual pathologic vessels may cause bleeding 8,15 . Several studies have also reported that embolization in cAVM may be useful in the management of patients presenting hard-to-control seizures, progressive neurological deficit, and headaches, and to improve cerebral perfusion 8,9,16 . In addition, embolization has been thought to be useful in the elimination of aneurysms, which are independent risk factors for hemorrhage 8,12,[16][17][18][19] .…”

mentioning

confidence: 99%

“…Several studies have also reported that embolization in cAVM may be useful in the management of patients presenting hard-to-control seizures, progressive neurological deficit, and headaches, and to improve cerebral perfusion 8,9,16 . In addition, embolization has been thought to be useful in the elimination of aneurysms, which are independent risk factors for hemorrhage 8,12,[16][17][18][19] . However, there are no conclusive data concerning the benefits of this procedure.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Does treatment with N-butyl cyanoacrylate embolization protect against hemorrhage in cerebral arteriovenous malformations?

Raupp

Fernandes

2005

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

OBJECTIVE: To assess the role of this procedure to prevent hemorrhage in cerebral arteriovenous malformations (cAVM). METHOD: Between 1992 and 2000, we studied 104 patients submitted to embolization as the main treatment. Patients were followed until hemorrhage or death. RESULTS: Follow-up ranged from 1.6 months to 8 years. The most frequent presentations were hemorrhage (50%) and seizures (38%). In addition, 40% were small (<30 mm); 56% were medium (30-60 mm). Obliteration was <1/3 in 11% of the cases; from 1/3 to <2/3 in 49%; >2/3 in 36%; complete in 5%. The risk of death was 1%/year, and of bleeding, 5.4%/year. Presentation with hemorrhage and low obliteration rate were the main factors associated with hemorrhage. CONCLUSION: cAVM embolization provides limited protection against hemorrhage with obliteration rates below 2/3. Presentation with hemorrhage is the main factor for predicting hemorrhage.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Does treatment with N-butyl cyanoacrylate embolization protect against hemorrhage in cerebral arteriovenous malformations?

Raupp

Fernandes

2005

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

show abstract

Experimental investigation of transvenous embolization of arteriovenous malformations using different in vivo models

Vollherbst

Hantz

Schmitt

et al. 2022

J NeuroIntervent Surg

View full text Add to dashboard Cite

BackgroundTransvenous embolization (TVE) is an emerging technique for the endovascular treatment of cerebral arteriovenous malformations (AVMs). The aim of this study was to investigate two in vivo AVM models and to assess TVE techniques using these models.MethodsBlood flow in the porcine rete mirabile (RM) was modified by either creating a carotid–jugular fistula or by placing a balloon guide catheter in the carotid artery. The RM was embolized with precipitating hydrophobic injectable liquid (PHIL) 25% via transarterial embolization (TAE; control group) and compared with TVE applying the transvenous retrograde pressure cooker technique and TVE using a Woven EndoBridge (WEB) device for flow control (n=6, respectively). The embolization extent (penetration of the RM), the number of events of reflux or embolization distal to the RM and the procedure times were assessed.ResultsThe modified RM could be successfully used for embolization in all cases. There were no significant differences regarding the outcome parameters between the two AVM models (fistula or balloon). TVE using the pressure cooker technique led to a higher extent of embolization (median 98.8% vs 63.5%; p=0.008), a lower number of reflux or distal embolization events (p<0.001) and a shorter procedure time (p<0.001) compared with conventional TAE. TVE using a WEB device for flow control was technically feasible and achieved a moderate extent of embolization (median 83.8%).ConclusionAfter surgical or endovascular modification, the porcine RM is a feasible in vivo AVM model for the investigation of TVE techniques. TVE using the pressure cooker technique is superior to conventional TAE in this experimental model.

show abstract

In Situ β-Irradiation of a Brain Arteriovenous Malformation Model

Roy

Soucy

Hartman

et al. 2005

Stroke

View full text Add to dashboard Cite

Background and Purpose-The treatment of large brain arteriovenous malformations (BAVMs) is challenging, and embolization alone is seldom curative. The study goal is to enhance the efficacy of arteriovenous malformation embolization by adding a ␤-emitting isotope to the embolic agent. Methods-The pig rete mirabile was used as a BAVM model. The body distribution of radioactivity was evaluated after selective rete injection of N-butyl,2-cyanoacrylate mixed with 131 I-lipiodol in 8 animals using immediate whole body ␥-scintigraphy. Activities within the whole rete mirabile and selected tissue samples were quantified with a gamma counter immediately after sacrifice. Two pigs were submitted to serial ␥-scintigraphies for 6 weeks to detect delayed isotope leaching. Long-term effects of in situ irradiation were evaluated using a mixture of 188 Re/N-butyl,2-cyanoacrylate in 8 pigs. In 1 animal, autoradiography was performed to evaluate local rete mirabile distribution of the radioactivity. Seven pigs were injected with 188 Re/glue in 1 rete mirabile and with glue only on the opposite side, and the degree of vascular occlusion of both sides was compared on histology at 2 (nϭ2) or 6 months (nϭ5).Results-There was negligible activity outside the target. Radiation caused occlusion of vessels unreached by the glue itself but in the vicinity of the radioactive source in 5 of 7 rete mirabile. Conclusions-Selective

show abstract

Transarterial Embolisation of Cerebral Arteriovenous Malformations

Cited by 12 publications

References 5 publications

Does treatment with N-butyl cyanoacrylate embolization protect against hemorrhage in cerebral arteriovenous malformations?

Does treatment with N-butyl cyanoacrylate embolization protect against hemorrhage in cerebral arteriovenous malformations?

Experimental investigation of transvenous embolization of arteriovenous malformations using different in vivo models

In Situ β-Irradiation of a Brain Arteriovenous Malformation Model

Contact Info

Product

Resources

About