Endovascular treatment of aneurysms associated with cerebral arteriovenous malformations: experiences after the introduction of Guglielmi detachable coils.

The authors have treated 172 patients with arteriovenous malformation (AVM) since 1993. Among them, 25 patients had aneurysms with a total number of 43. The aneurysms were divided into four groups; proper feeder aneurysm (4), flow-related distal aneurysm (beyond the circle of Willis or M1, 7), flow-related proximal aneurysm (26) and remote aneurysm (6). Guglielmi detachable coil (GDC) embolisation was performed in 12 patients with 15 aneurysms. Gamma knife radiosurgery for AVM was performed in 10 of those 12 patients. Two of the proper feeder aneurysms were embolised with liquid material, together with the corresponding part of the AVM. The other aneurysms were treated surgically (14) or observed (12). There was no bleeding from aneurysms after treatment. In conclusion, GDC embolisation is a useful treatment for aneurysms associated with AVM, especially if the AVM is treated by radiosurgery. Liquid embolisation of a proper feeder aneurysm is one of the treatment options. Ltd.