title: Predictors of total obliteration in endovascular treatment of cerebral arteriovenous malformations.
abstract: Endovascular therapy is a therapeutic option that can achieve total obliteration of cerebral arteriovenous malformations (AVMs). The objective of this study was to determine the predictive factors of total obliteration in the endovascular treatment of AVMs. A prospective study was carried out in 71 patients with cerebral AVMs having undergone 147 embolization sessions with n-BCA, performed between 2006 and 2011. A univariate analysis was carried out, followed by a logistic regression analysis to determine the predictive factors of total obliteration. Total obliteration was achieved in 18.3% of the patients and angiographic control after 12 months showed the permanency of total occlusion in 100% of the AVMs with initial total obliteration. Angiographic characteristics found favorable for total eradication were: AVM size under 3 cm and the presence of a single arterial pedicle. Predictive factors of total obliteration were an AVM diameter smaller than 3 cm (OR: 50.9; IC: 7.41 - 349, 0; P = 0.000), and opposing factors, a 3-6 cm diameter (OR: 11.7; IC: 2.49 - 55, 4; P = 0.002) and afferences of more than two vessels of the Willis polygon (OR: 7.0; IC: 1.12-43.9; P = 0.038). An AVM diameter smaller than 3 cm is a predictive factor of total obliteration. Total postembolization obliteration persisted in 100% of the cases after 12 months.
authors.affiliation: Interventional Neuroradiology Unit, Stroke Unit, Institute of Neurology and Neurosurgery, CIMEQ; La Habana, Cuba - jjordan@infomed.sld.cu.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Jordan
authors.affiliation: Interventional Neuroradiology Unit, Stroke Unit, Institute of Neurology and Neurosurgery, CIMEQ; La Habana, Cuba.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Llibre
authors.affiliation: Interventional Neuroradiology Unit, Stroke Unit, Institute of Neurology and Neurosurgery, CIMEQ; La Habana, Cuba.
authors.forename: Frank
authors.initials: F
authors.lastname: Vazquez
authors.affiliation: Department of Anesthesia, CIMEQ; La Habana, Cuba.
authors.forename: Raul Marino
authors.initials: RM
authors.lastname: Rodríguez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D002548:Cerebral Revascularization; D002648:Child; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: arteriovenous malformations; embolization; predictive factors; total obliteration