Blood pressure changes in feeders to cerebral arteriovenous malformations during therapeutic embolization.

We recorded blood pressures in feeding arteries of cerebral arteriovenous malformations with microcatheters before, during, and after embolization in awake patients. Our embolization results corroborate reports of intraoperative measurements that show an immediate increase in blood pressure after ligation. Demonstration of abrupt hemodynamic changes gives additional credence to the theory of normal perfusion pressure breakthrough and to theories of neurologic change based on vascular steal phenomena. Furthermore, pressure changes occurred earlier than visible slowing of flow during the embolization, suggesting that this is a more sensitive guide with which to monitor the progress of the embolization than is serial angiography.