[Intra operative embolization of unresectable cerebral arterio-venous malformations. Occlusion attempt by means of a delayed polymerization mixture. Report of two cases (author's transl)].
Two cases of unresectable intra-cranial arterio-venous malformation (AVM) are reported, treated by direct intra-operative embolization. A 50% mixture of Butyl-2-Cyano-Acrylate and Mono-Iodo-Stearate of Ethyle (Duroliopaque) was used after catheterization of some of the feeding cortical arteries. No intra-operative angiography was performed. The first patient, admitted after subarachnoid hemorrhage and presenting with a mild transient right hemiparesia and aphasia, showed evidence of a left temporal AVM with a left middle cerebral artery supply and contribution from the left cerebral posterior artery. The AVM was embolized with 3 cc of the mixture. A mild aphasia occurred after surgery and completely recovered after two weeks. Roughly half of the AVM was occluded on the postoperative angiograms. The second patient suffering from a long history of seizures had a huge right frontal AVM, with a right middle cerebral artery and right anterior cerebral artery supply, and contribution from a right lenticulostriate artery, the left anterior cerebral artery and the right posterior cerebral artery. The AVM was embolized with 7 cc of the mixture. A complete palsy of the left upper limb occurred after surgery, with complete recovery after two weeks. On the post-operative angiograms, more than three fourth of the AVM was occluded.
D000328:Adult; D004621:Embolization, Therapeutic; D004659:Enbucrilate / Q000627:therapeutic use*; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000628:therapy*; D007432:Intraoperative Period; D007459:Iodized Oil / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D013228:Stearates / Q000627:therapeutic use*; D013229:Stearic Acids / Q000627:therapeutic use*; D013997:Time Factors
D013228:Stearates; D013229:Stearic Acids; C024030:ethyl iodostearate; D007459:Iodized Oil; D004659:Enbucrilate
Embolisation per-opératoire des malformations artério-veineuses cérébrales inextirpables: tentative d'oblitération par un mélange à polymérisation retardée. A propos de deux cas.