[Interventional neuroradiology. A presentation with preliminary results]

Area of Science:

• Neurosurgery
• Interventional Neuroradiology
• Vascular Neurology

Background:

• Endovascular embolization is a critical treatment for various cerebrovascular diseases.
• Historically, different embolic agents and techniques have been employed with varying success rates and complication profiles.

Purpose of the Study:

• To evaluate the evolution of endovascular embolization techniques and outcomes for complex cerebrovascular lesions.
• To compare complication rates and treatment efficacy between two distinct treatment periods.

Main Methods:

• Retrospective analysis of 57 patients treated between 1981-1992 for arteriovenous malformations (AVM), dural arteriovenous malformations (DAVM), carotico-cavernous fistulas (CCF), giant aneurysms, and meningiomas.
• Comparison of techniques: predominantly balloon embolization in the first period (1981-1985) versus N-butyl-cyanoacrylate (NBCA) for AVM/DAVM and balloon technique for CCF/test occlusions in the second period (1988-1992).

Main Results:

• The overall complication rate decreased from 33% in the first period to 8% in the second period.
• Successful nidus occlusion (>50%) was achieved in 83% of AVMs.
• Two DAVMs showed size reduction and symptom improvement; three of five CCFs were occluded.

Conclusions:

• The shift towards NBCA embolization for AVMs and DAVMs, alongside refined techniques for CCFs, significantly improved safety and efficacy.
• Close collaboration between interventional neuroradiologists and neurosurgical teams is essential for managing these rare and complex conditions.