Embolization of Brain Arteriovenous IVlalformations: Results of 42 Cases Treated with N.B.C.A. and Flow-guided Microcatheter.
10.3348/jkrs.1994.30.4.597
- Author:
Dae Hee HAN
;
Moon Hee HAN
;
Sang Hyung LEE
;
Kee Hyun CHANG
;
Dong Gyu KIM
- Publication Type:Original Article
- MeSH:
Angiography;
Arteries;
Arteriovenous Malformations;
Brain*;
Cyanoacrylates;
Humans;
Neurologic Manifestations;
Spasm;
Thiopental
- From:Journal of the Korean Radiological Society
1994;30(4):597-604
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We report the results of embolization in 42 cases of brain arteriovenous malformation and discuss the technical problems. MATERIALS AND METHODS: Flow-guided microcatheter for the superselection of the feeding arteries and nbutyl cyanoacrylate as an embolic agent were used. Wire guided microcatheter and microparticle were used in two exceptional cases. As preembolization functional evaluation, 30--50mg of thiopental sodium solution was injected into the feeding arteries through superselected microcatheters in 40 cases with supratentorial lesions. RESULTS: There was no local arterial complication by injection of thiopental solution. Embolization caused a permanent neurologic deficit(mild to moderated hemiparesis) in 2 patients (4.8%) by a reflux of embolic agent or probable spasm of main arterial trunk. In 8 patients(19%), the AVMs were completely obliterated and 25 patients(60%) showed anglographic obliterations of 50--90% of the lesions. Embolization induced venous occlusion was demonstrated at post-embolization angiography in 6 patients, and 3 patients of them showed delayed and transient neurologic deficits. CONCLUSION: Embolization of cerebral AVM can be performed effectively and safely by a superselective method and appropriate functional evaluation. Superselective thiopental sodium injection is a safe and reliable test for the evaluation of local brain function before embolization.
