Outcome analysis of preoperative embolization with N-butyl cyanoacrylate in cerebral arteriovenous malformations.
OBJECTIVE
To determine the influence of preoperative N-butyl cyanoacrylate embolization on outcome in the treatment of cerebral arteriovenous malformations.


METHODS
Two groups were compared: 30 patients who underwent surgery and embolization versus 41 patients who underwent surgery only. Both groups were categorized by Spetzler-Martin grade and evaluated with the Glasgow Outcome Scale at various intervals. The long-term follow-up in months was, for surgery only, mean of 35 and range of 4 to 59, and for surgery and embolization, mean of 10 and range of 1 to 19).


RESULTS
The arteriovenous malformations in the surgery and embolization group had a larger average greatest diameter (4.2 +/- 1.5 cm versus 3.4 +/- 1.8 cm) and were of higher Spetzler-Martin grade (89% versus 68% grade III-V). No significant difference in the preoperative or immediate postoperative (less than 24 hours) Glasgow Outcome Scale was identified between the two groups. At I week after surgery, the surgery and embolization group displayed a significantly better outcome evaluation (70% versus 41% with Glasgow Outcome Scale score of 5). The long-term evaluation continued to favor the surgery and embolization patients (86% versus 66% with Glasgow Outcome Scale score of 5).


CONCLUSIONS
Preoperative N-butyl cyanoacrylate embolization improves postsurgical outcome.
DeMeritt
J S
JS
Department of Radiology, Columbia-Presbyterian Medical Center, New York, NY 10032, USA.
Pile-Spellman
J
J
Mast
H
H
Moohan
N
N
Lu
D C
DC
Young
W L
WL
Hacein-Bey
L
L
Mohr
J P
JP
Stein
B M
BM
D000328:Adult; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic; D004659:Enbucrilate; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011300:Preoperative Care
D004659:Enbucrilate