GLUE EMBOLISATION OF INTRACRANIAL AND EXTRACRANIAL ARTERIOVENOUS MALFORMATIONS

Authors

  • Francis Hui MBBS FRCR FAMS Department of Diagnostic Imaging, Tan Tock Seng Hospital
  • Kheng-Hin Lee MBBS FRCS (E) FRCS (G) FAMS Consultant Neurosurgeon, Gleneagles Hospital
  • Peck-Leong Ong MBBS FRACS Department of Neurosurgery, Tan Tock Seng Hospital
  • Samuel Ng MBBS FRCR FAMS Department of Diagnostic Imaging, Tan Tock Seng Hospital
  • Hong-Khim Boey MBBS FRCR FAMS Department of Diagnostic Imaging, Tan Tock Seng Hospital

Abstract

Anteriovenous malformations of the head are formidable to treat. Embolisation with N Butyl Cyanoacrylate glue was carried out in 22 patients; 16 had cerebral AVMs, 4 had facial AVMs and 2 patients had dural AVMs. Complete obliteration of the shunt by the endovascular route was achieved in 7 patients. Altogether, 15 patients were cured by embolisation alone or in combination with surgery. Embolisation enhanced subsequent surgical or radiosurgical management by reducing nidus size, occluding intra nidal aneurysms and decreasing flow through the shunt. 3 more patients have not completed surgery or are awaiting follow up after radiosurgery. 2 permanent complications occurred, one deficit was mild and the other moderate in severity. Glue embolisation was found to be very effective in the treatment of patients with intra and extracranial AVMs.

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References

Vinuela F. Functional Evaluation and embolization of intracranial arteriovenous malformations. In Vinuela F., Halbach VV, Dion JE. Inter- ventional Neuroradiology: Endovascular therapy of the central nervous system. New York Raven Press 1992; 77-86.

Olcott C., Newton T.H., Stoney R.J., Ehrenfeld W.K. Intra arterial embolization in the management of arteriovenous malformations. Surgery 1976; 79: 3-12.

Coel M.N. and Alksne J.F. Embolization to diminish high output failure secondary to systemic angiomatosis (Ullman's syndrome). Vasc Surg 1978; 12: 336-340.

Crawford PM, West CR, Chadwick DW, Shaw MDM. Arteriovenous malformations of the brain: natural history in unoperated patients. J Neurol Neurosurg, Psychiatry, 1986; 49: 1-10.

Ondra SL, Troupp H, George ED, Schwab K. The natural history of symptomatic arteriovenous malformations of the brain: A 24 year follow-up assessment. J Neurosurg 1990: 73: 387-91.

Willinsky R, Lasjaunias P, Terbrugge K, Pruvost P. Brain arteriovenous malformations: analysis of the angioarchitecture in relationship to hemorrhage (based on 152 patients explored and/or treated at the Hospital de Bicetre between 1981 and 1986) J Neuroradiol 1988; 15: 225-37.

Marks M, Lane B, Steinberg G, Chang P. Hemorrhage in Intracranial Arteriovenous Malformations: Angiographic determinants. Radiology 1990;176: 807-13.

Wolpert SM, Stein BB. Factors governing the course of emboli in the therapeutic embolization of cerebral arteriovenous malformation. Radiology 1979; 131: 125-131).

Mullan S, Kawanaga H et al. Microvascular embolisation of cerebral arteriovenous malfor- mations. J Neurosurg 1979; 51: 621-627.

Lasjaunias P., Berenstein A. Surgical Neuroan- giography Vol 2. (1987) Springer Verlag. Heidelberg, New York.

Wikholm G Occlusion of cerebral arteriovenous malformations with N-Butyl Cyanoacrylate is permanent. AJNR 1995; 16: 479-83.

Pelz DM, Lownie SP, Fox AJ, Hutton LC. Symptomatic pulmonary complications from liquid acrylate embolisation of brain arteriovenous malformations. AJNR 1995; 16: 19- 26.

Derdeyn CP, Moran CJ, Cross DT, Dietrich HH, Dacey RG. Polyvinyl alcohol particle size and suspension characteristics.AJNR 1995; 1335-43.

Germano IM, Davis RL,Wilson CB, Hieshima GB. Histo pathological follow up study of 66 cerebral arteriovenous malformations after therapeutic embolisation with polyvinyl alcohol. J. Neurosurg 1992; 76: 607-14.

Spetzler RF, Martin NA. A proposed grading system for arteriovenous malformations J Neurosurg. 1986; 65: 476-83.

Fox AJ, Pelz DM, Lee DH. Arteriovenous malformations of the brain: Recent results of endovascular therapy. Radiology 1990; 177: 51-7.

U HS, Kerber CW, Todd MM. Multi modality treatment of deep periventricular cerebral AVMs. Surg Neurol 1992; 38: 192-203.

Spetzler RF, Martin NA, Carter P, Flom RA, Raudzens PA, Wilkinson E. Surgical management of large AVMs by staged embolisation and operative excision. J Neurosurg 1987: 67: 17-28.

Dawson III RC, Tarr RW, Hecht ST, Jungreis CA, Lunsford LD, Coffey R, Horton JA. Treatment of arteriovenous malformations of the brain with combined embolization and stereotactic redio- AJNR surgery: Results after 1 and 2 years 1990; 11: 857-864.

Marks MP, Lane B, Steinberg GK, Fabrikant JI, Levy RP, Frankel KA, Phillips MH. Endovascular treatment of cerebral arteriovenous malformations following radiosurgery. AJNR 1993; 14: 297-303.

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Published

2023-03-30

How to Cite

1.
Hui MBBS FRCR FAMS F, Lee MBBS FRCS (E) FRCS (G) FAMS K-H, Ong MBBS FRACS P-L, Ng MBBS FRCR FAMS S, Boey MBBS FRCR FAMS H-K. GLUE EMBOLISATION OF INTRACRANIAL AND EXTRACRANIAL ARTERIOVENOUS MALFORMATIONS. ASEAN J Radiol [Internet]. 2023 Mar. 30 [cited 2024 Dec. 21];1(3):35-47. Available from: https://asean-journal-radiology.org/index.php/ajr/article/view/264

Issue

Vol. 1 No. 3 (1995): September-December

Section

Original Article

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