Complications of preoperative embolization of cerebral arteriovenous malformations

Christopher L. Taylor, Kim Dutton, George Rappard, G. Lee Pride, Robert Replogle, Phillip D. Purdy, Jonathan White, Cole Giller, Thomas A. Kopitnik, Duke S. Samson

Research output: Contribution to journalReview article

132 Scopus citations

Abstract

Object. Preoperative embolization is viewed by the authors as a useful adjunct in the surgical management of cerebral arteriovenous malformations (AVMs). This study was performed to determine the rate of significant complication in patients undergoing this procedure. Methods. Demographic, anatomical, and procedure data were collected prospectively. The treating physician reported complications. In addition, a review of medical records including procedure reports, operative reports, and discharge summaries was performed. Univariate statistical analysis was performed to determine if any of the variables was predictive of a poor outcome of embolization (death or permanent neurological deficit). Endovascular procedures for embolization were performed 339 times in 201 patients during an 11-year period. Female patients comprised 53.7% of the study group and 85.6% of the AVMs were supratentorial. Embolization was performed using polyvinyl alcohol particles, N-butyl cyanoacrylate, detachable coils, and/or the liquid polymer Onyx. Analyzed by procedure, a poor result of embolization occurred in 7.7%. Analyzed by patient, 11% died or had a permanent neurological deficit as a result of the embolization. None of the demographic, anatomical, or procedure variables identified were predictive of a poor outcome. Conclusions. Preoperative embolization may gradually reduce flow to an AVM, reduce intraoperative blood loss, and reduce operative time. The risks of this procedure, however, are not insignificant and must be considered in planning treatment for patients with AVMs.

Original languageEnglish (US)
Pages (from-to)810-812
Number of pages3
JournalJournal of neurosurgery
Volume100
Issue number5
DOIs
StatePublished - May 2004

Keywords

  • Arteriovenous malformation
  • Brain
  • Embolization
  • Endovascular therapy
  • Outcome analysis

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Taylor, C. L., Dutton, K., Rappard, G., Pride, G. L., Replogle, R., Purdy, P. D., White, J., Giller, C., Kopitnik, T. A., & Samson, D. S. (2004). Complications of preoperative embolization of cerebral arteriovenous malformations. Journal of neurosurgery, 100(5), 810-812. https://doi.org/10.3171/jns.2004.100.5.0810