Complications of cerebral arteriovenous malformation embolization: multivariate analysis of predictive factors.

摘要: OBJECTIVE Embolization is an important therapeutic modality in the multidisciplinary management of arteriovenous malformations (AVM); however, prior series have reported a wide variability overall complication rates caused by embolization (10-50% neurological deficit, 1-4% mortality). In this study, we reviewed our experience with AVM and analyzed factors that might predict complications clinical outcomes after embolization. METHODS We combined neurovascular unit's results from 1993 to 2004 for following measures: 1) clinically significant complications, 2) technical without sequelae, 3) discharge Glasgow Outcome Scale score, 4) death. To determine efficacy, perioperative blood transfusion rate obliteration. Univariate multivariate analyses were performed patient age, sex, history rupture, seizure, associated aneurysms, size, deep venous drainage, eloquent location, Spetzler-Martin grade, number stages, pedicles embolized, primary treatment modality. RESULTS Over 11 year period, 295 procedures (761 embolized) 168 patients as (n = 16) or adjunct surgery 124) radiosurgery 28). There total 27 series, which (6.5% patients, 3.7% per procedure), 16 (9.5% 5.4% procedure). Excellent good (Glasgow > observed 152 (90.5%) patients. Unfavorable 1-3) direct result both 3.0% at follow-up, 1.2% embolization-related mortality. 124 surgical 96.8% had complete obliteration initial resection, 31% received (mean 1.4 units packed red cells patient). Predictors unfavorable outcome univariate analysis drainage (P < 0.05), Grade III V periprocedural hemorrhage 0.0001) (odds ratio 10.6, P 0.03) 17, 0.004). CONCLUSION single-center, retrospective, nonrandomized 90.5% excellent embolization, lower than previously reported. grade most predictive determining