Does treatment with N-butyl cyanoacrylate embolization protect against hemorrhage in cerebral arteriovenous malformations?
OBJECTIVE
To assess the role of this procedure to prevent hemorrhage in cerebral arteriovenous malformations (cAVM).


METHODS
Between 1992 and 2000, we studied 104 patients submitted to embolization as the main treatment. Patients were followed until hemorrhage or death.


RESULTS
Follow-up ranged from 1.6 months to 8 years. The most frequent presentations were hemorrhage (50%) and seizures (38%). In addition, 40% were small (<30 mm); 56% were medium (30-60 mm). Obliteration was < or =1/3 in 11% of the cases; from 1/3 to < or = 2/3 in 49%; >2/3 in 36%; complete in 5%. The risk of death was 1%/year, and of bleeding, 5.4%/year. Presentation with hemorrhage and low obliteration rate were the main factors associated with hemorrhage.


CONCLUSIONS
cAVM embolization provides limited protection against hemorrhage with obliteration rates below 2/3. Presentation with hemorrhage is the main factor for predicting hemorrhage.
Raupp
Eduardo Floriani
EF
Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil. eraupp@uol.com.br
Fernandes
Jefferson
J
D000328:Adult; D004621:Embolization, Therapeutic; D004659:Enbucrilate / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000628:therapy*; D020300:Intracranial Hemorrhages / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016896:Treatment Outcome
D004659:Enbucrilate