Preoperative embolization of cerebral arteriovenous malformations with polyvinyl alcohol particles: Experience in 51 adults

P. D. Purdy, D. Samson, H. H. Batjer, R. C. Risser

Research output: Contribution to journalArticle

73 Scopus citations

Abstract

In order to determine possible risk factors and to assess the value of platinum microcoils added to polyvinyl alcohol particles in preoperative embolization of cerebral arteriovenous malformations in adults, we reviewed our experience with this procedure. Between September 1985 and June 1989, we performed embolizations in 54 patients with cerebral arteriovenous malformations. Of these, procedures in 51 adults involved the use of polyvinyl alcohol particles, either alone (n = 29) or in combination with platinum microcoils (n = 21). A complication during catherization precluded embolization in another patient. Beginning as flow-directed embolizations via carotid artery catheterizations (n = 12), newer catheters allowed progression to superselective intracerebral catheterizations (n = 38). Embolization has led to shorter surgical procedures, more clearly defined operative margins, and less bloody operative fields. We have not found recanalization to significantly hinder embolization results with polyvinyl alcohol when resection is undertaken within 1-4 weeks of embolization. Its relative safety and ease of manipulation at surgery argue for its use. We found no significant increase in complications based on patient age, venous drainage of the arteriovenous malformation, or the circulation embolized. Embolization results in cerebral arteriovenous malformations were improved with superselective catherization and most improved with the combined use of polyvinyl alcohol for nidus embolization followed by occlusion of the feeding vessel with microcoils.

Original languageEnglish (US)
Pages (from-to)501-510
Number of pages10
JournalAmerican Journal of Neuroradiology
Volume11
Issue number3
StatePublished - Jan 1 1990

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

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