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Updated: Jul 13, 2026
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
[Intraoperative angiography in the surgery of brain arteriovenous malformations]
Ge Yuan1, Ji Zong Zhao, Shuo Wang
1Department of Neurosurgery, Beijing Tiantan Hospital, Capital University of Medical Sciences, Beijing 100050, China.
Insights
Intraoperative angiography significantly improves brain arteriovenous malformation (AVM) surgery outcomes. This technique aids in detecting residual AVMs, preventing re-operations, and reducing complications, enhancing patient safety.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Diagnostic Imaging
Background:
- Brain arteriovenous malformations (AVMs) present complex surgical challenges.
- Accurate intraoperative assessment is crucial for successful AVM resection.
Purpose of the Study:
- To evaluate the efficacy of intraoperative angiography in brain AVM surgery.
- To assess its role in improving surgical outcomes and patient safety.
Main Methods:
- 41 patients with brain AVMs underwent surgery with intraoperative angiography.
- Femoral artery catheterization allowed for real-time imaging during AVM resection.
- Angiography was performed to confirm AVM resection status.
Main Results:
- Complete AVM resection was confirmed in 95% of patients (39/41) via intraoperative angiography.
- Residual AVMs in critical zones were identified and successfully resected.
- No mortality or angiography-related complications were observed.
Conclusions:
- Intraoperative angiography is a valuable tool for identifying residual AVM nidus.
- It assists surgeons in refining techniques and preventing re-operations.
- This method contributes to decreased cerebrovascular surgery complications.
Objective:
To evaluate the effect of intraoperative angiography in the surgery of brain arteriovenous malformations(AVMs).
Methods:
Between July 2003 and February 2006, 41 consecutive patients of brain AVMs (18 female and 23 male patients, mean age 34 years) underwent cerebrovascular surgery assisted with intraoperative angiography in our institute. The nidus diameters of AVMs were from 2 cm to 8 cm, including 10 cases of large AVMs (diametre >or=6cm) which accounted for 24%. After intubation was achieved and general anesthesia was administrated, the patient's right femoral artery was catheterized successfully with catheter reaching the intracranial artery during the surgery. When the AVMs were resected, the intraoperative angiography was performed.
Results:
Ten of 41 were patients underwent emergency operation because of acute intracranial hemorrhage without preoperative angiography, who were estimated as AVMs assisted with intraoperative angiography. The nidus had been totally resected in 39 of the 41 (95%) patients confirmed by intraoperative angiography, with 1 patient (2.4%) of motor dominant zone AVMs and 1 patient (2.4%) of posterior fossa AVMs had residual AVMs, which had been noted and resected. There was no operation mortality, no complication attributable to angiography. Intraoperative angiography consumed 25 to 130 minutes with mean time of 53 minutes.
Conclusion:
Intraoperative angiography can detect the location of small AVMs and unexpected residual AVMs nidus, help surgeons modify technical faults to prevent from re-operation, and decrease complication of cerebrovascular surgery.
