Jordán GJA, Llibre GJC, Vázquez LF, Rodríguez RRM, Ugarte SJC, Prince LJA

Language: Spanish
References: 10
Page: 12-19
PDF size: 423.35 Kb.

ABSTRACT

Introduction. Intracerebral arteriovenous malformations constitutes an uncommon disease, causing a hi gh morbidity and mortality. Endovascular treatment of Intracerebral arteriovenous malformations is a well established procedure and it´s usually combined with neurosurgery and/or radiosurgery. Our purpose was to compare the associated complications of endo vascular treatment of AVM in two different periods of time: 2004 -2006 and 2007-2009. Methods. We analyzed retrospectively the information gathered from the embolization of the AVM. In the first period of time several pedicles were occluded on the same sess ion with no hemodynamic management control after the procedure whatso ever, while in the second period of time procedure was more conservative, smaller areas were occluded , and hemodynamic control was established right afterwards. Results. In the first group of patients, 42 sessions of embolization were performed; the percentage of occlusion carried out was from 22-60%. Four hemorrhagic events occurred for 9.5% of hemorrhagic complications, there weren´t ischemic complications. In the second group , 45 procedures were performed with no hemorrhagic or ischemic complications at all. The percentage of embolization per session was from 10 -25%. Conclusions. The established hemodynamic management control has been a true neuroprotective mechanism in the endovascular t reatment of Intracerebral arteriovenous malformations , and it has contributed in a significant way to reduce morbidity and mortality.

REFERENCES

1. Mohr JP, Stein BM, Pile -Spellman J. Arteriovenous malformation. In: Barnett JM, Mohr JP, Stein BM, Yatsu FM, editors. Stroke. Pathophysiology, diagnosis, and management. 3rd ed. Phil adelphia: Churchill Livingstone; 1998. p. 725 -50.

2. Weigele JB, Hurst RW, Al -Okaili RN. Endovascular management of brain arteriovenous malformations. In: Hurst RW, Rosenwasser RH, editors. Interventional neuroradiology. New York: Informa Healthcare; 2008. p. 275- 303.

3. Linfante I, Wakhloo AK. Brain aneurysms and arteriovenous malformations advancements and emerging treatments in endovascular embolization. Stroke. 2007;38(4):1411-7.

4. Hartmann A, Pile-Spellman J, Stapf C. Risk of endovascular treatment of brain arteriovenous malformations. Stroke. 2002;33(7):1816 -20.

5. Friedlander RM. Arteriovenous malformations of the brain. N Engl J Med. 2007;356(26):2704-12.

6. Brown RD, Wiebers DO, Torner JC. Frequency of intracranial hemorrhage as a presenting symptom and subtype a nalysis: a population -based study of intracranial vascular malformations in Olmsted County, Minnesota. J Neurosurg. 1996;85(1):29-32.

7. Mast H, Young WL, Koennecke HC. Risk of spontaneous haemorrhage after diagnosis of cerebral arteriovenous malformation. La ncet. 1997;350(9084):1065 -8.

8. Pollock BE, Flickinger JC, Lunsford LD, Bissonette DJ, Kondziolka D. Factors that predict the bleeding risk of cerebral arteriovenous malformations. Stroke. 1996;27(1):1-16.

9. Heidenreich JO, Hartlieb S, Stendel R, Pietilä TA, Sc hlattmann P, Wolf K.-J, et al. Bleeding complications after endovascular therapy of cerebral arteriovenous malformations. AJNR Am J Neuroradiol. 2006;27(2):313-6.

10. Ledezma CJ, Hoh BL, Carter BS. Complications of cerebral arteriovenous malformation emboliza tion: multivariate analysis of predictive factors. Neurosurgery. 2006 Apr;58(4):602 -11.