Preliminary Analysis Of The Treatment Of Brain Arteriovenous Malformations By Embolization And Radiosurgery

Objective: To evaluate the effects of embolization and gamma kniferadiosurgery for cerebral arteriovenous malformations.Methods：60consecutive patients with cerebral AVMs treated withembolization and gamma knife radiosurgery were retrospectivelyreviewed. Demographics, including age, sex, presenting symptoms andangiographic factors, including AVM size, location, feeding arteries anddraining veins were recorded. Number of embolization sessions,obliteration rate, any complications and margin dose of gamma knifewere recorded. Follow-up data, including postoperative course, clinicalsymptoms and duration of follow-up were documented. Symptoms andimaging data before and after treatment were compared. Analyze the DSAresults and the effect of combined treatment.Results：We reviewed60patients harboring cerebral AVMs treated withendovascular embolization and gamma knife radiosurgery. There were36males and24females with a mean age of29.1years(range,8-52years).83embolizations(1.38sessions per patient, range1-4) were performed.Then65gamma knife radiosurgerys (1.08sessions per patient, range1-2)were performed. Imaging data (41/60) of follow-up showed that completeobliteration of cerebral AVMs were achieved in20patients, and thenumber of cases with nidus volume reduction was18,and3patients nidusvolume had not changed. There were a total of6complications. Therewere bleeding complications in5patients, ischemic complications in1patients. Procedure-related mild permanent disabling morbidity was2,. Conclusions：The combined treatment with embolization and gammaknife radiosurgery is effective method for the treatment of AVMs. It candiminish the size of an AVM before radiotherapy, so that thecomplications of cerebral AVMs treated with embolization and gammaknife radiosurgery are relatively rare，however，long time follow-up isnecessary.