American Journal of Neuroradiology, Vol 16, Issue 9 1801-1807, Copyright © 1995 by American Society of Neuroradiology
ARTICLES |
Outcome analysis of preoperative embolization with N-butyl cyanoacrylate in cerebral arteriovenous malformations
JS DeMeritt, J Pile-Spellman, H Mast, N Moohan, DC Lu, WL Young, L Hacein-Bey, JP Mohr and BM Stein
Department of Radiology, Columbia-Presbyterian Medical Center, New York, NY 10032, USA.
PURPOSE: To determine the influence of preoperative N-butyl cyanoacrylate embolization on outcome in the treatment of cerebral arteriovenous malformations. METHODS: Two groups were compared: 30 patients who underwent surgery and embolization versus 41 patients who underwent surgery only. Both groups were categorized by Spetzler-Martin grade and evaluated with the Glasgow Outcome Scale at various intervals. The long-term follow-up in months was, for surgery only, mean of 35 and range of 4 to 59, and for surgery and embolization, mean of 10 and range of 1 to 19). RESULTS: The arteriovenous malformations in the surgery and embolization group had a larger average greatest diameter (4.2 +/- 1.5 cm versus 3.4 +/- 1.8 cm) and were of higher Spetzler-Martin grade (89% versus 68% grade III-V). No significant difference in the preoperative or immediate postoperative (less than 24 hours) Glasgow Outcome Scale was identified between the two groups. At I week after surgery, the surgery and embolization group displayed a significantly better outcome evaluation (70% versus 41% with Glasgow Outcome Scale score of 5). The long-term evaluation continued to favor the surgery and embolization patients (86% versus 66% with Glasgow Outcome Scale score of 5). CONCLUSION: Preoperative N-butyl cyanoacrylate embolization improves postsurgical outcome.
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