Curative effect analysis of intracranial arteriovenous malformation treated by microsurgery or endovascular interventional embolization

• Published in: Zhongguo xian dai shen jing ji bing za zhi Vol. 17; no. 12; pp. 898 - 904
• Main Authors: CHENG, Lin, XUE, Zhe, Yu-dong, MA, Dong-sheng, KONG, Wen-xin, WANG, WU, Chen, Zheng-hui, SUN
• Format: Journal Article
• Language: Chinese; English
• Published: Tianjin Shi Tianjin Huanhu Hospital 25.12.2017
• Subjects: Angiography, digital subtraction; Embolization, therapeutic; Intracranial arteriovenous malformations; Microsurgery
• ISSN: 1672-6731
• DOI: 10.3969/j.issn.1672-6731.2017.12.007

Objective To explore the efficacy and safety of microsurgery and endovascular interventional embolization for treating intracranial arteriovenous malformation (AVM). Methods A total of 53 AVM patients underwent microsurgery (N = 27) and endovascular interventional embolization (N = 26). Postoperative DSA revealed the resection of malformed vessels and embolization. Surgery-related complications were recorded, and Glasgow Outcome Scale (GOS) was used to evaluate the prognosis one month after operation. Results In microsurgery group, postoperative re-examination revealed complete resection in 26 out of 27 cases, with the cure rate of 96.30% (26/27). After operation, limb movement disorder occurred in 2 cases (7.41% ), neurological dysfunction occurred in one case (3.70% ) and status epilepticus (SE) occurred in one case (3.70% ). The occurrence rate of postoperative complications was 14.81% (4/27). One month after operation, GOS showed 5 score in 15 cases (55.56%), 4 score in 10 cases (37.03%) and 3 score in 2 cases (7.41%). The rate of good prognosis was 92.59% (25/27). In endovascular interventional embolization group, postoperative re-examination revealed complete embolization in 8 out of 26 cases, with the cure rate of 30.77% (8/26). After operation, limb movement disorder occurred in 2 cases (7.69%) and neurological dysfunction occurred in 2 cases (7.69%). The occurrence rate of postoperative complications was 15.38% (4/26). One month after operation, GOS showed 5 score in 17 cases (65.38%), 4 in 7 cases (26.92% ) and 3 in 2 cases (7.69% ). The rate of good prognosis was 92.31% (24/26). Conclusions Microsurgery is a safe and effective treatment for intracranial AVM. Endovascular interventional embolization can also achieve good curative effect for patients with intracranial AVM under Puerto Rico scale ≤ 3 score. Multiple and staged embolization or embolization combined with radiotherapy can effectively relieve symptoms and improve prognosis for patients with complex intracranial AVM.