Objectives: (1) To report our institutional initial technical experience in the endovascular
management of cerebral arteriovenous malformations (AVMs). (2) To detect the clinical
outcome involving efficacy and complications of the endovascular management of cerebral
AVMs. Methods: This is a cross-sectional study involving 14 cases diagnosed as having cerebral AVMs,
who underwent diagnostic angiography and planned after written consent for a attempt
of endovascular embolization.
Our standard technique will be performed under a general anesthesia and get through
transfemoral artery approach Microcatheter will be advanced through a guiding catheter
to the arterial feeders supplying the cerebral AVMs. Onyx or Histoacryl was used as
embolizing agent for successfully navigated cerebral AVMs by microcatheter Immediate
follow-up conventional angiography was done to assess the size of residual AVM. Continuous
clinical and radiological follow-up of our cases is still running every 6 months.
Results: Technical results involved successful microcatheter navigation and embolization in
9 of 14 cases (64%) with failed microcatheter navigation in 2 of 4 cases (14%) and
failed embolization in 3 cases (22%). Clinical results involved controlled recent
intracranial hemorrhage on 2 of 3 cases (67%), controlled seizure on 2 of 5 cases
(40%), and complicated hemorrhage on 2 of 9 cases (22.2%) with one reported death.
Anatomical results more than 50% decreased size of 4 of 9 cases (44.4%) and less than
50% decreased size in 5 of 9 cases (55.5%). Conclusion: Endovascular embolization of cerebral AVMs by transfemoral artery approach using
microcatheter navigation and embolization has some technical difficulties with success
rate for navigation and embolization (64%). It is an effective treatment method to
control hemorrhagic cerebral AVMs, to decrease associated seizures, and to decrease
the size of cerebral AVMs.
