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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Progressive AVM Thrombosis after Onyx Embolization with Angiographic Cure
1Radiology Department, Indiana University School of Medicine; Indianapolis, IN, USA - iftikharbhutta@hotmail.com.
The Neuroradiology Journal
|September 14, 2013
Summary
Intracranial arteriovenous malformations (AVMs) can cause hemorrhage and seizures. This study reports an unexpected complete cure of a cerebral AVM after two embolization sessions, avoiding further treatment.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Neurosurgery
Background:
- Intracranial arteriovenous malformations (AVMs) carry significant risks, including hemorrhage and refractory seizures.
- Pre-surgical embolization is a common strategy to improve outcomes for cerebral AVMs.
Purpose of the Study:
- To report an unusual case of complete angiographic cure of a Spetzler-Martin grade 4 cerebral AVM following Onyx embolization.
- To highlight the potential for unexpected complete resolution of AVMs after staged embolization.
Main Methods:
- A 45-year-old male patient with a Spetzler-Martin grade 4 right occipital lobe AVM underwent staged embolization using Onyx 18.
- Angiography was performed after each embolization stage and six weeks post-second stage.
Main Results:
- The first embolization achieved 10% devascularization, and the second achieved 70% devascularization.
- Six weeks after the second embolization, follow-up angiography revealed a complete angiographic cure of the AVM, with no residual shunting.
Conclusions:
- Complete angiographic cure of a complex cerebral AVM can occur unexpectedly after staged embolization.
- This case suggests that embolization alone may achieve complete resolution in select AVM cases, potentially obviating the need for surgery or radiosurgery.
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