Retrospective analysis of the endovascular and surgical treatment outcomes in 105 patients with cerebral arteriovenous malformation

Abstract

Aims: We aimed to compare the short-term follow-up outcomes of treatment with liquid embolization agents in 105 patients with low- and medium-grade arteriovenous malformation (AVM) having supra- or infratentorial localization and its reliability and efficacy. Methods: This retrospective study assessed patients diagnosed with grade I, II, III, IV, and V infratentorial AVM according to the Spetzler–Martin grading system who received endovascular treatment and underwent surgical resection. The pre-treatment, post-treatment, preoperative, postoperative, and follow-up data and the electronic radiograph findings, epicrisis reports, and clinical follow-up reports were recorded and examined. Results: AVM was detected in 105 patients, who underwent 132 endovascular treatment sessions in total. Of the 105 patients, 47 were fed with a single venous system; 37 with two venous systems; and 21 with three or more venous systems. The mean follow-up duration was 28 months, and no patient presented with re-hemorrhage. Some of the complications associated with embolization were hemiparesis/hemiplegia, hemihypesthesia, hemorrhage and hematoma, vision disorders and alar defects, cranial nerve paralysis, and aphasia/dysphasia. Meanwhile, seven patients died after treatment. Conclusion: AVM treatment generally includes usage of gamma knife, endovascular treatment, surgical resection, or the combination of such treatments. If surgical resection is performed, a complete and absolute outcome can be achieved. However, complete treatment can be rarely achieved with endovascular therapy alone. Higher morbidity and mortality rates were observed in patients with hemorrhage than in those without.

Keywords

• Arteriovenous malformation
• Endovascular treatment
• Surgery
• Complication

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