Zhipeng Li 1 , Yu Chen 1 , Pingting Chen 2 , Ruinan Li 1 , Li Ma 1 , Debin Yan 1 , Haibin Zhang 1 , Heze Han 1 , Yang Zhao 3 , Yukun Zhang 3 , Xiangyu Meng 4 , Hengwei Jin 4 , Youxiang Li 4 , Xiaolin Chen 5,6,7 , Yuanli Zhao 5,3,6,7 Show Affiliations »
Abstract
BACKGROUND: To explore the hemodynamic changes after embolization of arteriovenous malformations (AVMs) using quantitative digital subtraction angiography (QDSA). METHODS: We reviewed 74 supratentorial AVMs that underwent endovascular embolization and performed a quantitative hemodynamic analysis comparing parameters in pre- and post-operative DSA in correlation with rupture. The AVMs were further divided into two subgroups based on the embolization degree: Group I: 0%-50%, Group II: 51%-100%. In the intergroup analysis, we examined the correlations between embolization degree and hemodynamic parameter changes. RESULTS: A longer time to peak (TTP) of the main feeding artery (OR 11.836; 95% CI 1.388 to 100.948; P=0.024) and shorter mean transit time (MTT) of the nidus (OR 0.174; 95% CI 0.039 to 0.766; P=0.021) were associated with AVM rupture. After embolization, all MTTs were significantly prolonged (P<0.05). The full width at half maximum (FWHM) duration of the main feeding artery was significantly shortened (P<0.001), and several hemodynamic parameters of the main draining vein changed significantly (TTP: prolonged, P=0.005; FWHM: prolonged, P=0.014; inflow gradient: decreased, P=0.004; outflow gradient: decreased, P=0.042). In the subgroup analysis, several MTT parameters were significantly prolonged in both groups (P<0.05), and the MTT increase rate in Group II was greater than in Group I (P<0.05). CONCLUSIONS: Embolization can significantly change the hemodynamics of AVMs, especially when an embolization degree >50% is obtained. Partial embolization may reduce the AVM rupture risk in hemodynamics perspective. © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.
BACKGROUND: To explore the hemodynamic changes after embolization of arteriovenous malformations (AVMs) using quantitative digital subtraction angiography (QDSA). METHODS: We reviewed 74 supratentorial AVMs that underwent endovascular embolization and performed a quantitative hemodynamic analysis comparing parameters in pre- and post-operative DSA in correlation with rupture. The AVMs were further divided into two subgroups based on the embolization degree: Group I: 0%-50%, Group II: 51%-100%. In the intergroup analysis, we examined the correlations between embolization degree and hemodynamic parameter changes. RESULTS: A longer time to peak (TTP) of the main feeding artery (OR 11.836; 95% CI 1.388 to 100.948; P=0.024) and shorter mean transit time (MTT) of the nidus (OR 0.174; 95% CI 0.039 to 0.766; P=0.021) were associated with AVM rupture. After embolization, all MTTs were significantly prolonged (P<0.05). The full width at half maximum (FWHM) duration of the main feeding artery was significantly shortened (P<0.001), and several hemodynamic parameters of the main draining vein changed significantly (TTP: prolonged, P=0.005; FWHM: prolonged, P=0.014; inflow gradient: decreased, P=0.004; outflow gradient: decreased, P=0.042). In the subgroup analysis, several MTT parameters were significantly prolonged in both groups (P<0.05), and the MTT increase rate in Group II was greater than in Group I (P<0.05). CONCLUSIONS: Embolization can significantly change the hemodynamics of AVMs, especially when an embolization degree >50% is obtained. Partial embolization may reduce the AVM rupture risk in hemodynamics perspective. © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.
Entities: Chemical
Keywords:
arteriovenous malformation; blood flow; embolic
Mesh： See more »
Substances： See more »
Year: 2021
PMID： 34872987 DOI： 10.1136/neurintsurg-2021-018187
Source DB: PubMed Journal: J Neurointerv Surg ISSN： 1759-8478 Impact factor: 8.572