The Hemorrhagic Risk Factors Of Brain Arteriovenous Malformation Associated With Aneurysm And Interventional Therapy

Objective:To explore all kinds of risk factors of hemorrhagic brain arteriovenous malformation and the bleeding risk factors and interventional strategies of brain arteriovenous malformation associated with aneurysm.Methods:105 patients with brain arteriovenous malformation were analyzed by digital subtraction retrospectively,clinical and imaging data of 42 cases of brain arteriovenous malformations associated with aneurysm were collected and analyzed.Related statistical analysis was used by chi-square test.According to the result of intraoperative angiography and analyzing the architectural characteristics of vessels the therapeutic schedule was formulated.After 3 months?6 months and 1 year,all patients were reviewed by digital subtraction angiography(DSA)to determine whether recurrence or not.Results:Univariate analysis suggested that factors were correlated to hemorrhagic presentation included the site and size of the lesion,the type and number of feeding arteries,the number and type of venous drainages,the form of draining vein,and co-existing arteriovenous fistula.Multiple factors Logistic analysis found that location,size,the type and amount of supplying arteries,the number of the draining vein and combined with arteriovenous fistula were the risk factors for hemorrhagic presentation,and drainage vein dilation might be a protective factor.The hemorrhage risk factors in brain arteriovenous malformations associated with aneurysm include lesions located in subtentorium,the diameter of the lesion<3cm,deep venous drainage,Spetzler-Martin grade ?-? and type ? and type ?Ha aneurysms of Redekop classification.Glasgow outcome score of 38 postoperative patients were more than 4 points,visual impaired happened in 1 patient.2 patients had indifferent degree of limb dysfunction,1 case died.There was no recurrence in all patients followed by DSA.Conclusion:Clinically for BAVM lesions located in the tent of meeting,or deep brain,deformity group<3 cm,the single venous drainage,merge and aneurysm,arteriovenous fistula is pure perforators of artery and blood supply artery BAVM patients should be processed as soon as possible,to reduce the morbidity and mortality rates of hemorrhage.The Bavarian aneurysm is more likely to bleed.? and ?a type aneurysms are more prone to bleeding,but ?6 and ? are also prone to bleeding,with severe bleeding consequences.Should abandon the type ?b and III artery can be viewed or after treatment can narrow point of view,and to lower the risk of aneurysm rupture bleeding treatment strategy should be taken to overcome the difficulty of treatment of weight should be clearly outweigh the possible complications of the treatment,to try and remove blood BAVM merger aneurysm higher rate of major threat.In the choice of the treatment method of BAVM combined aneurysm intervention,hemorrhage patients should be treated with priority.Not bleeding patients,type ? and type ?a aneurysm embolization,along with deformity arteriolar for small diameter blood or wear branch artery aneurysm should be preferential treatment,type?b and ? aneurysms in deformity arteriolar embolism completely before processing.