Curative effect analysis of intracranial arteriovenous malformation treated by microsurgery or endovascular interventional embolization

Abstract

Objective To explore the efficacy and safety of microsurgery and endovascular interventional embolization for treating intracranial arteriovenous malformation (AVM).  Methods A total of 53 AVM patients underwent microsurgery (N = 27) and endovascular interventional embolization (N = 26). Postoperative DSA revealed the resection of malformed vessels and embolization. Surgery-related complications were recorded, and Glasgow Outcome Scale (GOS) was used to evaluate the prognosis one month after operation.  Results In microsurgery group, postoperative re-examination revealed complete resection in 26 out of 27 cases, with the cure rate of 96.30% (26/27). After operation, limb movement disorder occurred in 2 cases (7.41% ), neurological dysfunction occurred in one case (3.70% ) and status epilepticus (SE) occurred in one case (3.70% ). The occurrence rate of postoperative complications was 14.81% (4/27). One month after operation, GOS showed 5 score in 15 cases (55.56%), 4 score in 10 cases (37.03%) and 3 score in 2 cases (7.41%). The rate of good prognosis was 92.59% (25/27). In endovascular interventional embolization group, postoperative re-examination revealed complete embolization in 8 out of 26 cases, with the cure rate of 30.77% (8/26). After operation, limb movement disorder occurred in 2 cases (7.69%) and neurological dysfunction occurred in 2 cases (7.69%). The occurrence rate of postoperative complications was 15.38% (4/26). One month after operation, GOS showed 5 score in 17 cases (65.38%), 4 in 7 cases (26.92% ) and 3 in 2 cases (7.69% ). The rate of good prognosis was 92.31% (24/26). Conclusions Microsurgery is a safe and effective treatment for intracranial AVM. Endovascular interventional embolization can also achieve good curative effect for patients with intracranial AVM under Puerto Rico scale ≤ 3 score. Multiple and staged embolization or embolization combined with radiotherapy can effectively relieve symptoms and improve prognosis for patients with complex intracranial AVM.

DOI: 10.3969/j.issn.1672-6731.2017.12.007