Abstract
This report reviews the cases of thirty-nine patients with cerebral arteriovenous malformations (AVMs) treated by transfemoral therapeutic embolization since our development of ethylene vinylalcohol copolymer (EVAL), a new type of liquid embolization material. The results and complications of these cases are reported. EVAL was used as the first choice on most occasions and polyvinyl alcohol (PVA) particles or platinum microcoils were utilized only as supplements as part of one procedure.
Twenty-four cases out of 39 were cured by partial embolization and following surgical removal of the residual nidus. The other 15 cases were treated by embolization alone. Among these 15 cases, complete occlusion was achieved in one case, 90 to 95% occlusion in two cases, 70 to 90% in one case, 50 to 70% in nine cases, and 30 to 50% in two cases.
Neurological deficits occurred in 11 cases including five transient ones. The occurrence of permanent neurological deficits was 15.4% (6/39). There were no deaths caused by any of the treatments. Rebleeding in the follow-up period after partial embolization occurred in three cases. With these encouraging results, we conclude that EVAL embolization is effective as an adjunctive or radical treatment of cerebral AVMs.
