Interventional Embolization Combined With Microsurgery In The Treatment Of High-grade Cerebral Arteriovenous Malformations

Objective To explore the clinical value and key points of one-stop interventional embolization combined with microsurgery in the treatment of high-grade cerebral arteriovenous malformations.Methods 33 patients with advanced arteriovenous malformation treated by interventional embolization combined with microsurgery were analyzed retrospectively.The history,clinical manifestations,imaging features,treatment indications and treatment results were analyzed.The results were evaluated by modified Rankin Scale(MRS score).Results 19 patients(57.6%)had hemorrhage,7 patients(21.2%)had epilepsy,6 patients(18.2%)had headache and 1 patient(3.0%)had progressive neurological deficit.According to spetzler Martin classification(SMG),7 cases(21.2%),22 cases(66.7%)and 4 cases(12.1%)were classified as III + level,IV level and V level.All the patients completed the embolization before operation and underwent the operation immediately.After the operation,32 patients(97.0%)were completely occluded and 1 patient was transferred to radiotherapy.No patients died.7 patients(21.2%)had complications in the treatment phase.The mean follow-up time was 9.6 months(3-36 months).31 patients had Mrs ≤ 2 points(93.9%),1 patient had mrs4 points(3.0%),and 1 patient had mrs5 points(3.0%).32 cases(97.0%)showed complete occlusion.No patients died.Conclusion Interventional embolization combined with microsurgery in the treatment of high-grade cerebral arteriovenous malformations can combine the advantages of two treatment methods,offset the defects of a single treatment scheme,and obtain a high rate of immediate occlusion and a relatively low rate of disability and mortality.