Efficacy and safety of endovascular embolization of cerebral AVM

Abstract

Background : Endovascular embolization of cerebral arteriovenous malformations (AVMs) has several bene fi ts including AVM occlusion and fl ow reduction in preparation for other treatment techniques. Aim and objectives : The aim was to assess the ef fi cacy and safety of endovascular embolization of cerebral AVM with different techniques and materials. Patients and methods : In a prospective and retrospective study, 22 patients diagnosed as having AVM or arteriovenous fi stula who underwent endovascular embolization at Neurosurgical Intervention Unit et al. Hussein University Hospital were recruited in the period from the beginning of January 2020 to the end of May 2022. The authors included patients aged above 1 month, diagnosed to have cerebral AVM or arteriovenous fi stula. Patients with recent cerebral hemorrhage were delayed for at least 2 weeks. The authors excluded patients with vein of Galen malformation, neonatal AVM, patients who underwent surgical excision, patients with contraindication to radiation or dye injection, and inaccessible endovascular techniques such as severely tortuous vessels. Results : In the current study, the mean age was 24.5 ± 14.7 years. Most cases were male (68.2%). Most cases (86.4%) manifested headache, 40.9% had hemorrhage, 31.8% had side weakness, and 27.3% had fi ts. Spetzler and Martin grade of the cerebral AVMs was signi fi cantly improved after embolization compared with the initial grading score ( P ¼ 0.002). Eight patients showed complete occlusion of nidus and 14 had partial occlusion according to Spetzler and Martin grade. After 3 months of follow-up, modi fi ed Rankin scale, epilepsy, and headache were improved. No patient had procedure-related complications. Conclusion : Endovascular embolization is safe and effective in patients with cerebral AVM