Transvenous embolization of brain arteriovenous malformations: a systematic review and meta-analysis

• Published in: Journal of neurosurgical sciences Vol. 63; no. 4; p. 468
• Main Authors: Fang, Yi-Bin, Byun, Jun-Soo, Liu, Jian-Min, Krings, Timo, Pereira, Vitor M, Brinjikji, Waleed
• Format: Journal Article
• Language: English
• Published: Italy 01.08.2019
• Subjects: Brain - surgery; Embolization, Therapeutic - adverse effects; Endovascular Procedures; Humans; Intracranial Arteriovenous Malformations - surgery; Research Design; Treatment Outcome
• ISSN: 0390-5616; 1827-1855
• DOI: 10.23736/s0390-5616.18.04342-4

The safety and efficacy of transvenous embolization of brain arteriovenous malformations (AVM) remains relatively poorly understood. We performed a systematic review of the literature to determine outcomes of transvenous embolization of brain AVMs. Data sources include Ovid MEDLINE, Ovid EMBASE and the Web of Science. All case series with four or more patients receiving transvenous embolization of brain AVMs published before September 2017 were included. A total of 8 series with 66 patients were included. All-cause mortality rate was 6.0% (95% CI: 0.0-11.0%). There were no cases of treatment related mortality. Overall good functional outcome rates were 89.0% (95% CI: 82.0-96.0%). Complete occlusion rates were 96.0% (95% CI: 91.0-100.0%). Technical complications rates were 8.0% (95% CI: 2.0-14.0%). Additional treatment rates were 6.0% (95% CI: 0.0-11.0%). Patients receiving transvenous embolization of AVMs experience good long-term clinical outcomes in nearly 90% of highly selected cases. Further large case series are needed to confirm the result.