Haemodynamic changes in arteriovenous malformations induced by superselective embolization: transcranial Doppler...

Area of Science:

• Neurosurgery
• Vascular Neurology

Background:

• Intracerebral arteriovenous malformations (AVMs) pose risks of intraoperative and postoperative complications, including re-bleeding and edema.
• AVMs with multiple feeders increase these risks, necessitating effective treatment strategies.

Purpose of the Study:

• To evaluate the efficacy of superselective embolization combined with microsurgical techniques for treating complex AVMs.
• To assess the role of transcranial Doppler sonography (TCD) in monitoring hemodynamic changes during AVM treatment.

Main Methods:

• Primary superselective embolization was used to exclude AVMs with multiple feeders.
• Microsurgical techniques were employed for residual angiomas after embolization.
• Transcranial Doppler (TCD) sonography measured blood flow velocities in feeding arteries and the circle of Willis before and after interventions.

Main Results:

• Superselective embolization successfully excluded AVMs, with TCD confirming reduced flow velocities.
• Post-intervention, decreased velocities in cerebral and feeding arteries indicated successful hemodynamic alteration.
• The combination of superselective embolization and microsurgery proved effective for large AVMs (>3 cm) with multiple feeders.

Conclusions:

• Superselective embolization followed by microsurgical resection is an optimal strategy for complex AVMs.
• TCD is a valuable tool for assessing the hemodynamic impact of AVM interventions.
• This combined approach reduces complications associated with AVM treatment.