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Updated: Aug 13, 2026
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
[Progression following the embolisation of 100 intracranial arteriovenous malformations]
E Angulo-Hervías1, A M Crespo-Rodríguez, M E Guillén-Subirán
1Servicio de Radiodiagnóstico, Sección de Neurorradiología, Hospital Universitario Miguel Servet, Zaragoza, Spain. elenenen2000@yahoo.es
Insights
Intracranial arteriovenous malformation (AVM) embolisation effectively reduced vascular risk factors and size for further treatment. While complete obliteration was achieved in 27% of cases, combined therapies offered higher success rates with acceptable risks.
Area of Science:
- Neurosurgery
- Interventional Radiology
- Vascular Neurology
Context:
- Intracranial arteriovenous malformations (AVMs) pose significant risks.
- Embolisation is a key treatment modality for AVMs.
- Evaluating outcomes of embolisation is crucial for treatment planning.
Purpose:
- To analyze the characteristics, progression, and outcomes of 100 intracranial AVM embolisations.
- To assess the effectiveness of embolisation in achieving AVM obliteration and reducing vascular risk factors.
- To determine the safety and efficacy of embolisation as a standalone or adjunctive therapy for AVMs.
Summary:
- 100 intracranial AVMs were treated with embolisation, with 203 sessions performed.
- Embolisation alone achieved complete obliteration in 27% of cases.
- Combined embolisation with radiosurgery (78% obliteration) or surgery (70% obliteration) yielded higher success rates. Vascular risk factors were eliminated in 65% of cases. Morbidity and mortality rates were 8% and 2%, respectively.
Impact:
- Embolisation is effective in managing vascular risk factors associated with AVMs.
- The procedure satisfactorily reduces AVM size, facilitating subsequent treatments.
- Acceptable morbidity and mortality rates support embolisation's role in AVM management.
Introduction:
We analysed the characteristics, progression and outcomes observed following the embolisation of 100 intracranial arteriovenous malformations (AVM) that were performed in order to achieve complete obliteration of the AVM, the elimination of associated vascular risk factors and also to reduce their size with a view to increasing the effectiveness of later treatments.
Patients And Methods:
The demographic and anatomical characteristics of 110 patients with AVM were analysed over a period of 13 years, and embolisation was performed in 100 of them. In all, 203 embolisation sessions were carried out with an average of 3 embolisations per patient. Of the 100 AVM that were embolised, 36 were AVM which were treated by embolisation with no later therapy, 48 required radiosurgery after the embolisation and the other 16 were submitted to surgery following the embolisation. The type of materials used included liquid adhesive embolic agents (Hystoacryl, Glubran), non-adhesive embolic agents (Onyx) and polyvinyl alcohol particles. Patients were examined clinically and arteriographically.
Results:
Of the 100 AVM that were embolised, complete eradication was accomplished with just embolisation in 27 cases of AVM (27%). Of the 48 AVM in which radiosurgery was carried out at a later date, the average rate of obliteration was 78% and of the 16 AVM in which surgery was carried out some time later, the average rate of obliteration was 70%. Of the 100 AVM that were embolised, some residue remained in 16 cases. Embolisation eliminated most of the associated vascular risk factors, as can be seen by the fact that associated risk factors disappeared in 28 (65%) out of the 43 AVM with such factors. The morbidity and mortality rates with embolisation were 8% and 2%, respectively.
Conclusions:
Embolisation eliminated most of the vascular risk factors, with complete obliteration in 27 cases and size was satisfactorily reduced for later treatment; at the same time, morbidity and mortality rates were acceptable.