Efficiency of endovascular embolization and predictors of postoperative complications in patients with different types of brain arteriovenous malformations
Patologiya krovoobrashcheniya i kardiokhirurgiya（2019）
Aim. (1) To evaluate the efficiency of endovascular embolization of brain arteriovenous malformations (AVMs) with seizure or hemorrhage in relation to radicalness and postoperative complication development and (2) to determine the predictors of postoperative complications after endovascular embolization of AVMs.
Methods. In this retrospective study, we examined the treatment of 192 patients with brain AVMs with seizure (seizure group; n = 85) or hemorrhage (hemorrhage group; n = 107). All the patients underwent total endovascular embolization of the malformations, and the follow-up period was 12 months. The two different patient groups were identified, and the predictors of the development of adverse events (hemorrhagic and ischemic complications) in the early postoperative period (hospital stay) were determined.
Results. Twelve months after control cerebral angiography was performed, recanalization was observed in 7 (8.2%) and 14 (13.1%) patients in the seizure and hemorrhage groups, respectively (p = 0.432). The frequency of complications was 20% and 29.9% in the seizure and hemorrhage groups, respectively (p = 0.162). The mortality rate during hospitalization was 0% and 9.3% in the seizure and hemorrhage groups, respectively (p = 0.026). Multivariate regression analysis revealed that a history of hemorrhage, the location of AVMs in functionally significant zones, and a large maximum size of AVMs are predictors of the development of postoperative complications.
Conclusion. Endovascular embolization is an effective, minimally invasive approach for the treatment of different types of brain AVMs. Considering the natural risks of brain AVMs according to the literature, endovascular embolization is associated with a low frequency of early postoperative complications.
Received 14 February 2019. Revised 24 May 2019. Accepted 28 May 2019.
Funding: The study did not have sponsorship.
Conflict of interest: Authors declare no conflict of interest.
