1.What is called arteriovenous malformation interventional embolization?
It is a treatment method to eliminate the lesion or reduce the size of the malformation by introducing various embolic substances (spring coil, real wire segment, Glubra, NBCA, ONYX gel, etc.) into the blood supply artery or malformation mass of arteriovenous malformation through micro catheter.
2.Who need interventional embolization of cerebral arteriovenous malformation
Embolization of simple malformed vessels and supplying cerebral arteries: It is applicable to non-functional areas, small vascular malformations, and simple lesions with only one supplying artery. Yu Yaoyu, Department of Neurosurgery, Affiliated Hospital of Armed Police Logistics College
②Embolysis of the supply artery of the malformed vessel before surgery; applicable to extensive or multiple lesions with high blood flow that cannot be resected, or used before resection of extensive vascular malformations as a preparatory procedure that can prevent postoperative hyperperfusion comorbidities.
③ Pre-treatment before gamma-knife radiation therapy. After the malformed vessels are reduced to a certain size (less than 3 cm) by embolization of the malformed vessels before surgery, γ-knife radiation therapy is performed.
3.The advantages and disadvantages of cerebral arteriovenous malformation embolization?
Advantages
①Minimally invasive to the whole body: little trauma to the brain tissue, no craniotomy, short operation time.
②No damage to the normal blood vessels around the vessels, which can reduce the complications of surgery.
③It can directly cure AVM.
④Creates favorable conditions for surgical resection or provides favorable conditions for radiation therapy.
⑤As a purely palliative treatment, it reduces the chance of rebleeding, improves cerebral blood supply, and alleviates patients’ symptoms.
Disadvantages
①Most of the treatments are aimed at pre-embolization before surgical resection or radiotherapy.
②The hematoma cannot be removed when the intracranial hematoma is large.
③The interventional catheter cannot be introduced into the malformed mass if the vascular tortuosity is severe.
④The risk of embolism formation distal to the draining vein, or breakthrough of normal perfusion pressure.
4.The surgical effect of cerebral arteriovenous malformation embolization?
The use of embolization alone to cure cerebral arteriovenous malformation still has limitations, and its success rate does not exceed 20%. Therefore, it is mainly adapted to the smaller superficial arteriovenous malformations in the parietal and temporal lobes. This procedure is mostly advocated as a preembolization prior to surgical microsurgical resection or radiation therapy.