title: Endovascular treatment of brain arteriovenous malformations using a liquid embolic agent: results of a prospective, multicentre study (BRAVO).
abstract: OBJECTIVE
  To evaluate the safety and efficacy of a new liquid embolic agent in brain arteriovenous malformation (bAVMs) embolisation.
  
  
  METHODS
  A prospective, multicentre series was conducted at 11 interventional centres in Europe to evaluate embolisation of bAVMs with the new liquid embolic agent. Technical conditions, complications, clinical outcome and anatomical results were independently analysed.
  
  
  RESULTS
  From December 2005 to December 2008, 117 patients (72 male; 45 female, aged 18-75 years) were included. Clinical presentation was mostly haemorrhage (34.2 %) and seizures (28.2 %). Most AVMs were located in the brain hemispheres (85.5 %). AVMs were <3 cm in 52.1 % of patients and ≥ 3 cm in 47.9 %. Morbidity was observed in 6/117 patients (5.1 %), related to haemorrhagic events in 2 cases and non-haemorrhagic complications in 4 cases. Five patients (4.3 %) died in relation to the treatment (bleeding in 4 patients and extensive venous thrombosis in 1). Complete occlusion of the AVM by embolisation alone was obtained in 23.5 % of patients. Complementary treatment was performed in 82.3 % of patients with partial AVM occlusion, mostly radiosurgery.
  
  
  CONCLUSIONS
  In this prospective, multicentre, European, observational series, the new liquid embolic agent proved to be suitable for BAVM embolisation, with acceptable morbidity and mortality and good efficacy.
  
  
  CONCLUSIONS
  • Numerous interventional techniques have been used to embolise brain arteriovenous malformations (AVMs). • This prospective multicentre study demonstrates the suitability of a liquid embolic agent. • The safety of treatment using Onyx is acceptable. • Such embolisation leads to complete AVM occlusion in 23.5 % of patients.
authors: Department of Radiology, Hôpital Maison-Blanche, Reims, France, lpierot@gmail.com.
authors: L
authors: L
authors: Pierot
authors: C
authors: C
authors: Cognard
authors: D
authors: D
authors: Herbreteau
authors: H
authors: H
authors: Fransen
authors: W J
authors: WJ
authors: van Rooij
authors: E
authors: E
authors: Boccardi
authors: A
authors: A
authors: Beltramello
authors: N
authors: N
authors: Sourour
authors: K
authors: K
authors: Kupcs
authors: A
authors: A
authors: Biondi
authors: A
authors: A
authors: Bonafé
authors: W
authors: W
authors: Reith
authors: A
authors: A
authors: Casasco
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy*; D004121:Dimethyl Sulfoxide / Q000627:therapeutic use*; D004621:Embolization, Therapeutic / Q000379:methods / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls / Q000627:therapeutic use*; D015995:Prevalence; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006490:Hemostatics; C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide
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