title: Superselective Intra-Arterial Ethanol Sclerotherapy of Feeding Artery and Nidal Aneurysms in Ruptured Cerebral Arteriovenous Malformations.
abstract: In the endovascular treatment of cerebral arteriovenous malformations, ethanol sclerotherapy is seldom used due to safety concerns. However, when limited reflux of an embolic agent is permissible or when there is a long distance to the target, ethanol may be preferable. We reviewed 10 patients with 14 cerebral AVM feeding artery aneurysms or intranidal aneurysms treated with intra-arterial ethanol sclerotherapy at our institution between 2005 and 2014. All patients presented with acute intracranial hemorrhage. Thirteen of 14 aneurysms were treated primarily with 60%-80% ethanol into the feeding artery. Complete target feeding artery and aneurysm occlusion was seen in all cases; 8/13 (62%) were occluded by using ethanol alone. No retreatments or recurrences were seen. One permanent neurologic deficit (1/13, 7.7%) and no deaths occurred. In a subset of ruptured cerebral AVMs, ethanol sclerotherapy of feeding artery aneurysms and intranidal aneurysms can be performed with a high degree of technical success and a low rate of complication.
authors.affiliation: From the Division of Interventional Neuroradiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California. fabio.settecase@ucsf.edu.
authors.forename: F
authors.identifier: http://orcid.org/0000-0002-5829-3163
authors.initials: F
authors.lastname: Settecase
authors.affiliation: From the Division of Interventional Neuroradiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California.
authors.forename: S W
authors.identifier: http://orcid.org/0000-0001-5885-7259
authors.initials: SW
authors.lastname: Hetts
authors.affiliation: From the Division of Interventional Neuroradiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California.
authors.forename: A D
authors.identifier: http://orcid.org/0000-0002-9304-5210
authors.initials: AD
authors.lastname: Nicholson
authors.affiliation: From the Division of Interventional Neuroradiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California.
authors.forename: M R
authors.identifier: http://orcid.org/0000-0002-8209-0534
authors.initials: MR
authors.lastname: Amans
authors.affiliation: From the Division of Interventional Neuroradiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California.
authors.forename: D L
authors.identifier: http://orcid.org/0000-0002-3694-413X
authors.initials: DL
authors.lastname: Cooke
authors.affiliation: From the Division of Interventional Neuroradiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California.
authors.forename: C F
authors.identifier: http://orcid.org/0000-0003-2267-4244
authors.initials: CF
authors.lastname: Dowd
authors.affiliation: From the Division of Interventional Neuroradiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California.
authors.forename: R T
authors.identifier: http://orcid.org/0000-0002-8863-2656
authors.initials: RT
authors.lastname: Higashida
authors.affiliation: From the Division of Interventional Neuroradiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California.
authors.forename: V V
authors.identifier: http://orcid.org/0000-0001-7138-2307
authors.initials: VV
authors.lastname: Halbach
mesh_terms: D000293:Adolescent; D000328:Adult; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000000981:diagnostic imaging; D057510:Endovascular Procedures / Q000379:methods; D000431:Ethanol / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D007269:Injections, Intra-Arterial; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000139:chemically induced / Q000209:etiology; D012008:Recurrence; D012421:Rupture / Q000188:drug therapy; D015911:Sclerotherapy / Q000009:adverse effects / Q000379:methods*; D013345:Subarachnoid Hemorrhage / Q000188:drug therapy / Q000628:therapy
chemical_list: D000431:Ethanol