The Hemodynamic Changes in Patients with Cerebral Arteriovenous Malformations before and after Interventional Embolization Therapy with Glubran 2 Acrylic Glue

2017 ◽  
Vol 78 (3-4) ◽  
pp. 169-175
Author(s):  
Qi-Yu Chen ◽  
Xiao-Rui Zhu ◽  
Yu Zhang
Keyword(s):  
Arteriovenous Malformations ◽  
Cerebral Arteriovenous Malformations ◽  
Hemodynamic Changes ◽  
Embolization Therapy ◽  
Before And After ◽  
Glubran 2 ◽  
Acrylic Glue

scholarly journals Curative Glubran 2 Embolization of Cerebral Arteriovenous Malformations Patient Selection and Initial Results

2014 ◽  
Vol 20 (6) ◽  
pp. 722-728 ◽  
Author(s):  
Jie Liu ◽  
Ming Lv ◽  
Xianli Lv ◽  
Hongwei He ◽  
Aihua Liu ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Arteriovenous Malformations ◽  
Gamma Knife Radiosurgery ◽  
Clinical Results ◽  
Hemorrhagic Complication ◽  
Cerebral Arteriovenous Malformations ◽  
Complete Obliteration ◽  
Glubran 2 ◽  
Cerebral Avms

The liquid embolic agents currently used for embolization of cerebral arteriovenous malformations are Onyx and NBCA. Glubran 2, a cyanoacrylate-based synthetic glue, has recently been applied for embolization of cerebral arteriovenous malformations (AVMs). We report the clinical results of selected cerebral AVMs treated with Glubran 2 targeting for curative embolization. Between October 2011 and March 2013, 31 patients with cerebral AVMs were selected for curative embolization with Glubran 2. There were 19 men and 12 women with a mean age of 32 years (range 4–65 years). Initial clinical presentation included hemorrhage in 28 and seizures in three patients. AVM location was frontal in eight patients, parietal in four, occipital in eight temporal in six, cerebellar in two and cerebellar vermis in three patients. Follow-up was performed clinically and with angiography examination at three to six months. Clinical outcomes were evaluated based on the modified Rankin Scale (mRS). A mean of 2.5 (range, 1–12) feeding pedicles were embolized per patient. Complete angiographic obliteration of AVM was achieved in 27 patients. A hemorrhagic complication was observed in one patient, an ischemic complication in one patient and technical complications in four patients. There was no procedure-related disabling neurological deficit or death at discharge. Additional gamma knife radiosurgery was performed in five patients, including one patient with recurrent AVM. All of the patients had favorable clinical outcomes at three to six month follow-up (mRS≤2). The curative embolization technique with Glubran 2 for selected cerebral AVMs achieved a high initial complete obliteration rate with an acceptable complication frequency.

scholarly journals Hemodynamic Changes in Drainage Systems following Treatment of Cerebral Arteriovenous Malformations

2001 ◽  
Vol 7 (1_suppl) ◽  
pp. 89-98 ◽  
Author(s):  
S. Miyachi ◽  
M. Negoro ◽  
T. Okamoto ◽  
G. Otsuka ◽  
O. Suzuki ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Type A ◽  
Type B ◽  
Cerebral Arteriovenous Malformations ◽  
Hemodynamic Changes ◽  
Drainage Systems ◽  
Shunt Flow ◽  
Type D ◽  
Type C

The authors studied 61 patients undergoing effective embolization for cerebral arteriovenous malformations (AVMs) and analyzed the hemodynamic changes in their drainage systems following embolization. The changes were classified into following 5 types: type A, disappearance of all the draining veins; type B, disappearance of a part of the cortical veins; type C, disappearance of a part of the deep-seated veins; type D, combined type B and C patterns; type E, disappearance of reflux into normal cortical veins. Each case was evaluated on the basis of these criteria from comparing pre- and post-embolization angiograms. The delay and reduction of shunt were observed in all cases. Forty-nine of them showed obvious hemodynamic changes in the draining systems including type A change in 9, type B in 19, C in 5, D in 3 and E in 13 cases, respectively. Two cases showed a spontaneous shift in the dominance of the main drainers. Thirteen of 15 cases showing successful results in subsequent radiosurgery exhibited various changes in draining pattern. Changes in drainage systems may be affected by the compartmentalization of the nidus, reduction in shunt flow, and spontaneous or progressive thromboses. These can be promoted by embolization and may be regarded as one of the indicators of successful pretreatment for radiosurgery.

scholarly journals Results of surgical treatment after Gamma Knife radiosurgery for cerebral arteriovenous malformations: patient series

2021 ◽  
Vol 1 (25) ◽  
Author(s):  
Atsushi Shimizu ◽  
Koji Yamaguchi ◽  
Yoshikazu Okada ◽  
Takayuki Funatsu ◽  
Tatsuya Ishikawa ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Arteriovenous Malformations ◽  
Gamma Knife Radiosurgery ◽  
Neurological Deficits ◽  
Surgical Removal ◽  
Cerebral Arteriovenous Malformations ◽  
First Line Therapy ◽  
Symptomatic Intracerebral Hemorrhage ◽  
Before And After ◽  
Complete Obliteration

BACKGROUND Gamma Knife radiosurgery (GKRS) is a safe and effective treatment, but it has a risk of bleeding. Herein, the authors describe their experience with some patients who required surgical removal of cerebral arteriovenous malformations (AVMs) located mainly in eloquent areas of the brain after GKRS, and they consider the advantages of surgical removal after GKRS. OBSERVATIONS Twelve patients who had undergone surgical removal of AVMs after GKRS at Tokyo Women’s Medical University between April 2013 and July 2019 were selected for analysis. All participants underwent GKRS as first-line therapy for AVMs located in an eloquent region or if requested by the patient. Complete obliteration was achieved in 7 patients, and the size of the nidus decreased in 3 patients during the follow-up period. The Spetzler-Martin grade decreased in 11 patients. Three patients experienced symptomatic intracerebral hemorrhage before and after confirmation of complete obliteration of the nidus via GKRS, and 7 patients experienced some neurological deficits because of an encapsulated expanding hematoma. All patients underwent resection of the nidus without complications. The preoperative neurological deficits improved in 6 patients and remained unchanged in 6 patients. LESSONS This report indicates that performing GKRS before surgery may be useful for future multimodal therapy.

The Göteborg Cohort of Embolized Cerebral Arteriovenous Malformations: A 6-year Follow-up

Neurosurgery ◽  
2001 ◽  
Vol 49 (4) ◽  
pp. 779-806 ◽  
Author(s):  
Gunnar Wikholm ◽  
Christer Lundqvist ◽  
Pål Svendsen
Keyword(s):  
Arteriovenous Malformations ◽  
Clinical Course ◽  
Cerebral Arteriovenous Malformations ◽  
Stereotactic Irradiation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Lost To Follow Up ◽  
Acrylic Glue

Abstract OBJECTIVE To present a follow-up of the results after endovascular treatment of cerebral arteriovenous malformations (AVMs) with acrylic glue. An initial follow-up was published in 1996. METHODS A cohort of 150 patients with cerebral AVMs underwent embolization between 1987 and 1993. Fifty-seven patients had supplemental stereotactic irradiation, and 13 had subsequent surgery. The follow-up was carried out clinically and radiologically. RESULTS The mean follow-up time was 6.2 years. Only four patients were lost to follow-up. If at least 90% of the AVM had been obliterated, the clinical course was stable and there were no new manifestations from the AVM. No recanalization occurred in any AVM that had been totally obliterated with glue. For patients in whom it was not possible to totally obliterate the AVM either with glue alone or glue supplemented with stereotactic irradiation or surgery, the long-term outcome was discouraging. CONCLUSION Obliteration of an AVM with acrylic glue seems to offer stability. If the AVM is totally obliterated, the patient had a stable clinical course. Patients with large AVMs with minor occlusion after embolization may have a worse clinical outcome than expected.

scholarly journals Anesthesia-related considerations for cerebral arteriovenous malformations

2001 ◽  
Vol 11 (5) ◽  
pp. 1-6 ◽  
Author(s):  
Tomoki Hashimoto ◽  
William L. Young
Keyword(s):  
Arteriovenous Malformations ◽  
Anesthetic Management ◽  
Cerebral Arteriovenous Malformations ◽  
Hemodynamic Changes ◽  
Cerebral Hemodynamic

In the optimum anesthetic management of patients with cerebral arteriovenous malformations (AVMs), the anesthesiologist should be familiar with the general pathophysiology of these lesions and various strategies for treatment. In this review, the authors outline these issues with special attention to cerebral hemodynamic changes induced by AVMs and their resection.

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