Preoperative Embolization of Cerebral Arteriovenous Malformations with Onyx

被引:38
作者
Hauck, E. F. [1 ]
Welch, B. G. [1 ,2 ]
White, J. A. [1 ]
Purdy, P. D. [2 ]
Pride, L. G. [2 ]
Samson, D. [1 ]
机构
[1] Univ Texas SW Med Ctr Dallas, Dept Neurosurg, Dallas, TX 75390 USA
[2] Univ Texas SW Med Ctr Dallas, Dept Neuroradiol, Dallas, TX 75390 USA
关键词
ENDOVASCULAR TREATMENT; BRAIN; COMPLICATIONS;
D O I
10.3174/ajnr.A1376
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND AND PURPOSE: Preoperative embolization facilitates the surgical management of complex cerebral arteriovenous malformations (cAVMs). This analysis aims to investigate the risks for preoperative cAVM embolization with Onyx. MATERIALS AND METHODS: We retrospectively analyzed clinical data of all patients who underwent embolization with Onyx as a preoperative treatment of cAVMs at our institution since 2005 (US Food and Drug Administration [FDA] approval). Patients with arteriovenous fistulas were excluded. A total of 107 patients were treated for cAVMs during the study period. Of those patients, 41 underwent cAVM embolizations with Onyx in 82 procedures. RESULTS: After the embolization, the cAVM diameter was reduced from 3.71 +/- 1.55 cm to 3.06 +/- 1.89 cm (P <.05). Median volume reduction was 75%. Complete occlusion with embolization alone was achieved in 4 (10%) cAVMs. The recurrence rate for completely occluded cAVMs was 50% (2 patients). A total of 71% of the 41 patients treated with Onyx underwent surgery, and 15% underwent radiosurgery. There were 9% who have not yet received definitive treatment of their residual cAVMs. A new permanent neurologic deficit occurred in 5 patients (6.1% per procedure or 12.2% per patient). CONCLUSIONS: A considerable risk for a permanent neurologic deficit remains for cAVM embolization with Onyx. The risk has to be carefully weighted against the benefit of volume reduction in the treatment of cAVMs.
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收藏
页码:492 / 495
页数:4
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