Endovascular treatment of cerebral arteriovenous malformations

Background: In this paper we present our results of treating cerebral arteriovenous malformations implementing percutaneous embolization between 2001-2003. Material/Methods: From year 2001 to 2003, a group of 34 patients underwent endovascular embolization of cerebral arterio venous malformations. This group consisted of 10 female and 24 male patients aged 15 to 78 (mean: 45.3). DSA examination was performed to assess the possibility of percutaneous embolization. Microcatheters 1.2 F, 1.5 F, or 1.8 F were used in accordance with the dimensions of the malformation. The tip of the catheter was placed close to the nidus of the malformation. Results: Cerebral arteriovenous malformations were localized mainly in the temple region (38%) or in the parietal region (27%). Primary embolization resulted in total occlusion in 41% of AVMs fed by up to three vessels. Repeated interventions led to occlusion of the additional hemangiomas in up to 70.5% of all lesions. In cases of AMVs fed by more than 4 vessels, the second embolization did not result in total occlusion of the hemangiomas. Curative results were obtained in only 12 patients (35%). Total or partial occlusion resulted in the partial reduction of the diameters of the malformations by 30 to 80% (mean: 74%). Conclusions: The best results of embolization were achieved in cases of small and medium malformations fed by 1-3 vessels (70.5% of cases). In our opinion, percutaneous embolization could be applied as an independent curative method in adult patients with small and medium arteriovenous malformations, grades I - III the Spetzler-Martine scale.