title: Endovascular treatment of deep hemorrhagic brain arteriovenous malformations with transvenous onyx embolization.
abstract: Brain AVMs are a rare cause of cerebral hemorrhage and SAH, and their treatment is still debated. The aim of this study was to describe a novel endovascular approach with transvenous embolization of deep hemorrhagic brain AVMs. Five patients (3 females, 2 males; mean age, 33.2 years) underwent a transvenous embolization of a deep hemorrhagic brain AVM at our institution between February and April 2012. Clinical and angiographic data at the end of the procedure and after 6 months are reported. All the AVMs were completely obliterated, and no intra- or postprocedural complications occurred. The clinical outcome was unchanged or improved in all patients. Transvenous endovascular treatment may be considered in small, hemorrhagic, and deep AVMs with single deep drainage in those cases in which neurosurgical and radiosurgical treatment might not be indicated.
authors.affiliation: Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Consoli
authors.forename: L
authors.initials: L
authors.lastname: Renieri
authors.forename: S
authors.initials: S
authors.lastname: Nappini
authors.forename: N
authors.initials: N
authors.lastname: Limbucci
authors.forename: S
authors.initials: S
authors.lastname: Mangiafico
mesh_terms: D000328:Adult; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control*; D002648:Child; D004121:Dimethyl Sulfoxide / Q000627:therapeutic use*; D004621:Embolization, Therapeutic / Q000379:methods*; D057510:Endovascular Procedures; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls / Q000627:therapeutic use*; D011859:Radiography; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006490:Hemostatics; C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide
references.citation: Neurosurgery. 2008 Jun;62(6):1213-25; discussion 1225-6
references.pmid: 18824988
references.citation: Neurosurgery. 1996 Sep;39(3):460-7; discussion 467-9
references.pmid: 8875475
references.citation: Neurosurgery. 2007 Aug;61(2):244-52; discussion 252-4
references.pmid: 17762736
references.citation: Neurosurgery. 1999 Aug;45(2):351-63; discussion 363-5
references.pmid: 10449081
references.citation: Eur J Radiol. 2003 Jun;46(3):195-205
references.pmid: 12758114
references.citation: J Neurointerv Surg. 2010 Jun;2(2):150-2
references.pmid: 21990597
references.citation: J Neurol. 2000 Dec;247(12):917-28
references.pmid: 11200683
references.citation: Neurosurgery. 1994 Jan;34(1):2-6; discussion 6-7
references.pmid: 8121564
references.citation: Lancet. 2002 Mar 9;359(9309):863-73
references.pmid: 11897302
references.citation: Neurosurgery. 2006 Nov;59(5 Suppl 3):S148-57; discussion S3-13
references.pmid: 17053597
references.citation: J Neurosurg. 1995 Feb;82(2):190-5
references.pmid: 7815145