OBJECTIVE: To estimate for hemorrhage risk of partially endovascularly embolized brain arteriovenous malformation (BAVM). METHODS: We retrospectively reviewed 147 consecutive patients with BAVM-treated mainly with endovascular N-butyl cyanoacrylate (NBCA) and ONYX embolization. In Kaplan-Meier survival analysis, the index date was the dated of initial endovascular embolization; cases were censored at time of subsequent intracranial hemorrhage (ICH), or loss to follow-up, and multivariate proportional-hazards regression models included age of presentation (≤30 years old), clinical presentations, and other potential confounders. RESULTS: We reviewed 147 patients with BAVM (58.8% male; mean age±SD at treatment: 27.5±11.1 years) treated with endovascular embolization. One hundred and forty-four NBCA and 76 ONYX embolizations were performed. Complete obliteration of BAVMs was achieved in 29 patients (19.7%). Thirty-two (21.8%) patients were treated with additional Gamma-knife radiosurgery. During 499.5 years of follow-up, 15 partially treated patients suffered a further hemorrhage, which caused four deaths. The crude annual risk of hemorrhage was 3.0% and the annual death rate was 0.8%. Among partially treated patients with hemorrhage at initial presentation, the risk of hemorrhage was 3.8%, while the risk of hemorrhage for patients without hemorrhage at initial presentation was 2.5%. The annual rate of subsequent hemorrhage was 2.6% for non-ICH and 4.2% for ICH in the partial NBCA embolization group compared with 2.4% for non-ICH and 2.4% for ICH in the partial ONYX embolization group. CONCLUSIONS: The effect of partial AVM embolization with liquid embolic agents may still be unclear as for risk reduction of annual hemorrhage rate of cerebral AVM.
OBJECTIVE: To estimate for hemorrhage risk of partially endovascularly embolized brain arteriovenous malformation (BAVM). METHODS: We retrospectively reviewed 147 consecutive patients with BAVM-treated mainly with endovascular N-butyl cyanoacrylate (NBCA) and ONYX embolization. In Kaplan-Meier survival analysis, the index date was the dated of initial endovascular embolization; cases were censored at time of subsequent intracranial hemorrhage (ICH), or loss to follow-up, and multivariate proportional-hazards regression models included age of presentation (≤30 years old), clinical presentations, and other potential confounders. RESULTS: We reviewed 147 patients with BAVM (58.8% male; mean age±SD at treatment: 27.5±11.1 years) treated with endovascular embolization. One hundred and forty-four NBCA and 76 ONYX embolizations were performed. Complete obliteration of BAVMs was achieved in 29 patients (19.7%). Thirty-two (21.8%) patients were treated with additional Gamma-knife radiosurgery. During 499.5 years of follow-up, 15 partially treated patients suffered a further hemorrhage, which caused four deaths. The crude annual risk of hemorrhage was 3.0% and the annual death rate was 0.8%. Among partially treated patients with hemorrhage at initial presentation, the risk of hemorrhage was 3.8%, while the risk of hemorrhage for patients without hemorrhage at initial presentation was 2.5%. The annual rate of subsequent hemorrhage was 2.6% for non-ICH and 4.2% for ICH in the partial NBCA embolization group compared with 2.4% for non-ICH and 2.4% for ICH in the partial ONYX embolization group. CONCLUSIONS: The effect of partial AVM embolization with liquid embolic agents may still be unclear as for risk reduction of annual hemorrhage rate of cerebral AVM.
Authors: David Altschul; Srinivasan Paramasivam; Santiago Ortega-Gutierrez; Johanna T Fifi; Alejandro Berenstein Journal: Childs Nerv Syst Date: 2014-03-27 Impact factor: 1.475
Authors: S A Ansari; S Schnell; T Carroll; P Vakil; M C Hurley; C Wu; J Carr; B R Bendok; H Batjer; M Markl Journal: AJNR Am J Neuroradiol Date: 2013-05-02 Impact factor: 3.825
Authors: N Schmitt; R O Floca; D Paech; R A El Shafie; F Seker; M Bendszus; M A Möhlenbruch; D F Vollherbst Journal: AJNR Am J Neuroradiol Date: 2020-11-19 Impact factor: 3.825
Authors: Brian Fiani; Marisol Soula; Kasra Sarhadi; Daniel Nikolaidis; Neha Gautam; Nicholas J Fiani; Ryne Jenkins; Alexander Rose Journal: Surg Neurol Int Date: 2021-03-30