Evaluation of theTherapeutic Effect of the Hybrid Operation on Patients with Aneurysms Associated with Cerebral Arteriovenous Malformations with different Redekop Classifications

• Published in: Journal of stroke and cerebrovascular diseases Vol. 31; no. 8; p. 106514
• Main Authors: Chao, Zhang, Peng, Li, Ling, Liu, Xiaosong, Liu, Gengshen, Zhang, Lei, Zhao, Tangkai, Xiaomeng, Liu, Xiaoliang, Wang, Jianliang, Wu
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2022
• Subjects: Cerebral arteriovenous malformation; Flow-related aneurysms; Hybrid operation; Redekop classification; AVMs; Redekop classification; ICA; BI; ACoA; MCA; Flow-related aneurysms; Cerebral arteriovenous malformation; ICH; mRS; CTA; DSA; Hybrid operation; WFNSS; IVH; SAH; VA-BA; ACA
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2022.106514

•Aneurysms associated with AVMs often with more severe neurological impairment.•Hybrid operation has higher one-stage cure rate and lower recurrence rate in flow-associated aneurysms.•Safety and effectiveness are similar to interventional therapy.•Hybrid operation is preferred in the treatment of aneurysms associated with AVMs. Intracranial aneurysms associated with cerebral arteriovenous malformations (AVMs) are a rare condition in the clinic, and treatment is very difficult due to their particular anatomical features. We present our experience in the treatment of intracranial aneurysms with AVMs and evaluate the effectiveness and safety of endovascular treatment combined with microsurgical resection (the hybrid operation). This was a single-center retrospective study in our neurosurgical department from January 2015 to January 2021. We collected clinical data from 48 patients with intracranial aneurysms associated with AVMs and categorized them according to Redekop classifications according to the results of cerebral imaging examination to compare the therapeutic effects of endovascular embolization and the hybrid operation. Compared to nonaneurysmal AVMs, intracranial aneurysms with AVMs more often presented with intracranial hemorrhage (P<0.05). Massive hematoma and severe neurological impairment were more often found in patients with intracranial aneurysms with AVMs (P<0.05). For flow-related aneurysms, the hybrid surgery had a higher one-stage cure rate than endovascular embolization alone (P<0.05). Both treatment methods had similar effects on intranidal aneurysms (P>0.05). There were no significant differences in prognostic indicators between the two treatments. However, the recurrence rate of AVMs with proximal flow-related aneurysms was lower in patients who underwent the hybrid operation (P<0.05). The hybrid operation was safe and effective for patients with intracranial aneurysms associated with AVMs. For flow-related aneurysms, the one-stage cure rate was higher and the recurrence rate was lower with the hybrid operation than with endovascular embolization alone.