G Wikholm1, C Lundqvist, P Svendsen. 1. Department of Interventional Neuroradiology, Sahlgrenska University Hospital, S-400 36 Göteborg, Sweden. gunnar.wikholm@xray.gu.se
Abstract
OBJECTIVE: To present a follow-up of the results after endovascular treatment of cerebral arteriovenous malformations (AVMs) with acrylic glue. An initial follow-up was published in 1996. METHODS: A cohort of 150 patients with cerebral AVMs underwent embolization between 1987 and 1993. Fifty-seven patients had supplemental stereotactic irradiation, and 13 had subsequent surgery. The follow-up was carried out clinically and radiologically. RESULTS: The mean follow-up time was 6.2 years. Only four patients were lost to follow-up. If at least 90% of the AVM had been obliterated, the clinical course was stable and there were no new manifestations from the AVM. No recanalization occurred in any AVM that had been totally obliterated with glue. For patients in whom it was not possible to totally obliterate the AVM either with glue alone or glue supplemented with stereotactic irradiation or surgery, the long-term outcome was discouraging. CONCLUSION: Obliteration of an AVM with acrylic glue seems to offer stability. If the AVM is totally obliterated, the patient had a stable clinical course. Patients with large AVMs with minor occlusion after embolization may have a worse clinical outcome than expected.
OBJECTIVE: To present a follow-up of the results after endovascular treatment of cerebral arteriovenous malformations (AVMs) with acrylic glue. An initial follow-up was published in 1996. METHODS: A cohort of 150 patients with cerebral AVMs underwent embolization between 1987 and 1993. Fifty-seven patients had supplemental stereotactic irradiation, and 13 had subsequent surgery. The follow-up was carried out clinically and radiologically. RESULTS: The mean follow-up time was 6.2 years. Only four patients were lost to follow-up. If at least 90% of the AVM had been obliterated, the clinical course was stable and there were no new manifestations from the AVM. No recanalization occurred in any AVM that had been totally obliterated with glue. For patients in whom it was not possible to totally obliterate the AVM either with glue alone or glue supplemented with stereotactic irradiation or surgery, the long-term outcome was discouraging. CONCLUSION: Obliteration of an AVM with acrylic glue seems to offer stability. If the AVM is totally obliterated, the patient had a stable clinical course. Patients with large AVMs with minor occlusion after embolization may have a worse clinical outcome than expected.
Authors: Robert M Starke; Ricardo J Komotar; Marc L Otten; David K Hahn; Laura E Fischer; Brian Y Hwang; Matthew C Garrett; Robert R Sciacca; Michael B Sisti; Robert A Solomon; Sean D Lavine; E Sander Connolly; Philip M Meyers Journal: Stroke Date: 2009-05-28 Impact factor: 7.914