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Embolization of rolandic cortex arteriovenous malformations.
R D Paulsen1, G K Steinberg, A M Norbash
1Department of Radiology, Stanford University Medical Center, California 94305-5105, USA.
Neurosurgery
|March 9, 1999
Summary
Pre-treatment embolization of rolandic arteriovenous malformations (AVMs) is safe and effective. This procedure significantly reduces AVM size with a low complication rate, paving the way for further treatment.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Neurosurgery
Background:
- Arteriovenous malformations (AVMs) in the rolandic cortex present unique treatment challenges.
- Pre-treatment evaluation is crucial for optimizing outcomes in AVM management.
Purpose of the Study:
- To assess the safety and efficacy of presurgical and preradiosurgical embolization for rolandic cortical AVMs.
- To determine the complication rate and success of embolization in reducing AVM size.
Main Methods:
- Seventeen patients with rolandic AVMs underwent superselective sodium amobarbital testing and somatosensory evoked potentials (SSEPs) to assess neurological function.
- Embolization was performed using N-butyl cyanoacrylate and iophendylate, with strict control of mean arterial pressure post-procedure.
- Patients were monitored for neurological deficits and AVM size reduction.
Main Results:
- Embolization was successfully performed in 15 of 17 patients, with significant AVM size reduction (mean 63%).
- No permanent complications occurred; four patients experienced transient neurological deficits that resolved.
- Two patients could not undergo embolization due to positive amobarbital test results.
Conclusions:
- Presurgical and preradiosurgical embolization of rolandic AVMs is a safe and effective procedure when appropriate pre-treatment evaluations are conducted.
- The technique achieves high success rates in terms of embolization completion and lesion size reduction with a low complication profile.