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Journal of Neurosurgical Sciences 2019 August;63(4):468-72

DOI: 10.23736/S0390-5616.18.04342-4


lingua: Inglese

Transvenous embolization of brain arteriovenous malformations: a systematic review and meta-analysis

Yi-Bin FANG 1, 2 , Jun-Soo BYUN 2, 3, Jian-Min LIU 1, Timo KRINGS 2, Vitor M. PEREIRA 2, Waleed BRINJIKJI 2, 4, 5

1 Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China; 2 Division of Neuroradiology and Neurosurgery, Toronto Western Hospital and University Health Network, University of Toronto, Toronto, ON, Canada; 3 Department of Radiology, Chung-Ang University Hospital, Seoul, South Korea; 4 Department of Radiology, Mayo Clinic, Rochester, MN, USA; 5 Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA

INTRODUCTION: The safety and efficacy of transvenous embolization of brain arteriovenous malformations (AVM) remains relatively poorly understood. We performed a systematic review of the literature to determine outcomes of transvenous embolization of brain AVMs.
EVIDENCE ACQUISITION: Data sources include Ovid MEDLINE, Ovid EMBASE and the Web of Science. All case series with four or more patients receiving transvenous embolization of brain AVMs published before September 2017 were included.
EVIDENCE SYNTHESIS: A total of 8 series with 66 patients were included. All-cause mortality rate was 6.0% (95% CI: 0.0-11.0%). There were no cases of treatment related mortality. Overall good functional outcome rates were 89.0% (95% CI: 82.0-96.0%). Complete occlusion rates were 96.0% (95% CI: 91.0-100.0%). Technical complications rates were 8.0% (95% CI: 2.0-14.0%). Additional treatment rates were 6.0% (95% CI: 0.0-11.0%).
CONCLUSIONS: Patients receiving transvenous embolization of AVMs experience good long-term clinical outcomes in nearly 90% of highly selected cases. Further large case series are needed to confirm the result.

KEY WORDS: Arteriovenous malformations; Therapeutic embolization; Catheter ablation; Endovascular procedures

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