PURPOSE: Previous reports of embolization of cerebral arteriovenous malformations (AVMs) have evaluated the technique as adjunctive therapy prior to surgery or radiosurgery; our aim is to assess the role of embolization following radiosurgery. PATIENTS: Six patients previously treated with radiosurgery and showing no response as judged by cerebral angiography were embolized 24 to 55 months (mean 34.3 months) after initial radiosurgery. RESULTS: In five of six, a significant volume reduction was achieved ranging from 60%-100% (mean 74%). One patient was treated with embolization alone and the AVM has remained fully thrombosed 2 years after treatment. Three patients underwent surgical resection for cure after embolization, and two patients had repeat radiosurgery to a significantly smaller AVM volume. One patient had an asymptomatic carotid dissection at embolization; however, no clinically apparent complications occurred in the treatment group. CONCLUSION: Embolization can be used after radiosurgery to assist in the management of those AVMs that have not responded to initial treatment.
PURPOSE: Previous reports of embolization of cerebral arteriovenous malformations (AVMs) have evaluated the technique as adjunctive therapy prior to surgery or radiosurgery; our aim is to assess the role of embolization following radiosurgery. PATIENTS: Six patients previously treated with radiosurgery and showing no response as judged by cerebral angiography were embolized 24 to 55 months (mean 34.3 months) after initial radiosurgery. RESULTS: In five of six, a significant volume reduction was achieved ranging from 60%-100% (mean 74%). One patient was treated with embolization alone and the AVM has remained fully thrombosed 2 years after treatment. Three patients underwent surgical resection for cure after embolization, and two patients had repeat radiosurgery to a significantly smaller AVM volume. One patient had an asymptomatic carotid dissection at embolization; however, no clinically apparent complications occurred in the treatment group. CONCLUSION: Embolization can be used after radiosurgery to assist in the management of those AVMs that have not responded to initial treatment.
Authors: Ahmed J Awad; Brian P Walcott; Christopher J Stapleton; Dale Ding; Cheng-Chia Leed; Jay S Loeffler Journal: J Clin Neurosci Date: 2015-04-23 Impact factor: 1.961
Authors: Christian Dorfer; Thomas Czech; Gerhard Bavinzski; Klaus Kitz; Aygül Mert; Engelbert Knosp; Andreas Gruber Journal: Childs Nerv Syst Date: 2009-11-28 Impact factor: 1.475