Endovascular Treatment Of Arteriovenous Malformation With Intracranial Aneurysms

Objects To research for the endovascular treatment and detailed methodof arteriovenous malformation (AVM) with intracranial aneurysm, especiallyfor both of lesion locating in the same feeding artery.Methods Retrospectively analysed16AVM with intracranial aneurysmlocating in the same feeding artery from Jun.2011to Jun.2013in our hospital.And the intracranial aneurysm locates in the proximal of the AVM in everycase. All the patients graded by Hunt-Hess Grade, including9Hunt-Hess IGrade cases,3Hunt-Hess II Grade cases and4Hunt-Hess III Grade cases.16cases are classified into4types by the relationship of anatomy andhemodynamics and the international classification. The first type (Type II,5cases): the intracranial aneurysm lies near to the opening of the feeding artery,far from the AVM. The second type (Type III,3cases): the intracranialaneurysm lies far from the opening of the feeding artery, near to the AVM. Thethird type (Type IV,6cases): the intracranial aneurysm lies in the nest of AVM.The fourth type (2cases): mixed type of above-mentioned Type II and Type III.According to the clinical classification, there are2different kinds ofendovascular treatments. The first type: After coiling the proximal intracranialaneurysm loosely, coiled the AVM with liquid glue. The second type: coiledthe intracranial aneurysm and AVM with liquid glue synchronously. Results The effect of treatment is assessed by GOS.15of16cases havegood prognosis, no morbidity and mortality. They are recognized GOS V. Onlyonce case had the right limb weakness postoperatively, but could keepindependent living, so it was recognized GOS IV. All the patients werefollow-up visited by DSA for3-6months after leaving hospital, and bytelephone for6month-3years.Conclusion Simultaneous endovascular treatment of AVM withintracranial aneurysm locating in the same feeding artery can require goodprognosis. The selection of surgical project depends on assessing sufficientlythe anatomic and hemodynamic relation between AVM and intracranialaneurysm.