Successful Operation for a Large High-flow Arteriovenous Malformation under Intraoperative Monitoring and Regulation of Cerebral Blood Flow

Abstract

The authors proposed a new technique for excision of a large high flow arteriovenous malformation to prevent normal perfusion pressure breakthrough. Selverstone carotid clamps was applied intra- and postoperatively to regulate cerebral blood flow. This procedure was combined with intraoperative cortical blood flow measurement.
According to the follow-up result of our 106 surgical cases, surgical risks were analized by an angiographical grading. The mechanism of normal perfusion pressure breakthrough was also discussed from our experience and literature. Criteria to apply this technique was also discussed. The authors present a case in which a large, high flow arteriovenous malformation was totally excised using this technique. Preoperative, intraoperative and postoperative cerebral blood flow measurement strongly suggested the usefulness of this technique for the safe excision of a large high-flow arteriovenous malformation.