J Korean Radiol Soc.  1994 Apr;30(4):597-604.

Embolization of Brain Arteriovenous IVlalformations: Results of 42 Cases Treated with N.B.C.A. and Flow-guided Microcatheter

• Han DH
• Han MH
• Lee SH
• Chang KH
• Kim DG

Abstract

PURPOSE
We report the results of embolization in 42 cases of brain arteriovenous malformation and discuss the technical problems.
MATERIALS AND METHODS
Flow-guided microcatheter for the superselection of the feeding arteries and nbutyl cyanoacrylate as an embolic agent were used. Wire guided microcatheter and microparticle were used in two exceptional cases. As preembolization functional evaluation, 30--50mg of thiopental sodium solution was injected into the feeding arteries through superselected microcatheters in 40 cases with supratentorial lesions.
RESULTS
There was no local arterial complication by injection of thiopental solution. Embolization caused a permanent neurologic deficit(mild to moderated hemiparesis) in 2 patients (4.8%) by a reflux of embolic agent or probable spasm of main arterial trunk. In 8 patients(19%), the AVMs were completely obliterated and 25 patients(60%) showed anglographic obliterations of 50--90% of the lesions. Embolization induced venous occlusion was demonstrated at post-embolization angiography in 6 patients, and 3 patients of them showed delayed and transient neurologic deficits.
CONCLUSION
Embolization of cerebral AVM can be performed effectively and safely by a superselective method and appropriate functional evaluation. Superselective thiopental sodium injection is a safe and reliable test for the evaluation of local brain function before embolization.

MeSH Terms

Angiography
Arteries
Arteriovenous Malformations
Brain*
Cyanoacrylates
Humans
Neurologic Manifestations
Spasm
Thiopental
Cyanoacrylates
Thiopental