Endovascular Treatment of Cerebral AVM-Associated False Aneurysms: Protective Role of Embolization against Rebleeding in the Acute Phase of Hemorrhage

Aims: This study investigates safety and efficacy of endovascular treatment for cerebral AVM-associated false aneurysms considered the source of hemorrhage, with special emphasis on its protective effect against rebleeding in the acute phase of hemorrhage.

Methods: Between December 2005 and March 2012, we identified 25 patients with ruptured false aneurysms contiguous to the site of cerebral AVMs rupture. The GCS and mRS scores were used to assess prospectively hemorrhagic stroke severity and clinical outcome.

Results: 31 false aneurysms associated with cerebral AVMs were included and treated. Patients were divided in two groups, in the first group of 17 patients, the mean time to treatment was 30.1 hours, while in the second group it was 17 days. All false aneurysms were totally occluded. Four patients presented a rebleeding before treatment (mean interval 9.6 days) and four had rebleeding after treatment (mean interval 8.25 months). At a mean follow-up of 56 months 21 patients were alive (19 mRS≤2, 2 mRS>2). Three patients died 2, 9 days and 2 months after bleeding and another died of rebleeding of her residual AVM 19 months after treatment. Treatment-related morbidity and mortality were respectively 4% and 0%.

Conclusions: Endovascular treatment is a safe procedure to secure false aneurysms associated with ruptured AVMs and could be effective to reduce the immediate risk of rebleeding.

Note: References will be provided on request by authors.