J Cerebrovasc Endovasc Neurosurg.  2023 Mar;25(1):36-49. 10.7461/jcen.2023.E2022.06.003.

Clinical and anatomic description of patients with arteriovenous malformation treated with endovascular therapy in a Mexican population

• Pelayo-Salazar ME
• Montenegro-Rosales HA
• Balderrama-Bañares JL
• Martínez-Arellano P
• Campos-Flota OA
• Mestre-Orozco L
• López-Valdés JC

• KMID: 2540806
• DOI: http://doi.org/10.7461/jcen.2023.E2022.06.003

Abstract

Objective
Arteriovenous malformations (AVMs) are benign congenital lesions. The estimated prevalence is 10-18 per 100,000 individuals, with an incidence rate of 1.1-1.4 per 100,000 person-year; only 12% of AVMs present symptoms during life. It is important to study different characteristics associated with AVMs because these patients require multidisciplinary treatment.
Methods
A descriptive, observational, longitudinal, and retrospective study was carried out from January 15, 2016 to October 19, 2021. Convenience sampling was used on patients diagnosed with arteriovenous malformation. Sociodemographic data was obtained, such as: sex, age, site, predominant symptoms, clinical debut, type of malformation, data associated with post therapy evolution, type of embolizing agent used, associated complications, Rankin scale, and death.
Results
Data from 535 procedures was collected, we calculated an incidence of 4.4 cases per million inhabitants. Ninety procedures in 56 patients that used endovascular therapy were obtained with a female-male ratio of 0.75 and an age distribution of 35±14 (SD). A 36.3±11.5 (SD) mm diameter was registered. There was a 33% success rate for endovascular surgery.
Conclusions
The multidisciplinary treatment of AVMs is made up of three pillar techniques: microsurgical resection, embolization, and radio-neurosurgery. It is extremely important to make an appropriate decision, with an emphasis on achieving better functional outcomes for the patient. Although neurological endovascular therapy was initially used as an adjuvant treatment for neurosurgery and radio-neurosurgery, it has been used more and more frequently as the first line of treatment.

Keyword

Arteriovenous malformation; Endovascular therapy; Coils; Embolization

Figure

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  Fig. 1. Flowchart for the patient selection.

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  Fig. 2. The graphic shows the most common localization for AVMs. AVMs, arteriovenous malformations

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  Fig. 3. Comparative graphic between Spetzler-Martin classification and Lawton-Young scale and Buffalo score.

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