Article Figures & Data
Figures
- Fig 1.
PVA group treatment flow chart.
- Fig 2.
n-BCA group treatment flow chart.
Tables
n-BCA PVA Number of patients 52 50 Spetzler grade, mean (number in each grade 1–5) 2.9(5,13,20,11,3) 2.9(5,14,17,10,3) Volume(cm3) 22.2 21.7 >6 cm 4 4 Deep venous drainage 26 23 Age (mean years) 40.5 37.6 Sex 33 male: 19 female 27 male: 23 female History Intracerebral hemorrhage 14 12 Subarachnoid hemorrhage 7 3 Seizures 24 21 Altered mental status 6 6 Pounding/pulsatile headache 14 15 Physical examination deficits Vision 7 7 Motor/Coordination 10 11 Sensory 6 6 Speech 4 6 Mentation 6 3 % Pretreatment Glasgow Outcome Scale score = 5 93.5% 87.5% Note.—n-BCA indicates n-butyl cyanoacrylate; PVA, polyvinyl alcohol.
n-BCA PVA Number of patients 52 49 Number of stages 77 86 Duration of embolization (min) 178 168 Duration of fluoroscopy (total min) 93.8 109.6 Coils used (stages) 15 61* Coils used (mean) 204(14.4)** 559(10.0)% Number of patients, no coils used 39 9 Particle size used among procedures <500 μm 18(36.7%) <500 μm only, no coils 5(10.6%) 500–710 μm 42(29.6%) 710–1000 μm 22(15.5%) 1000–1400 μm 5(3.5%) Infusion catheters 3-French infusion 31(31.3%) 53(52%) Flow-directed catheter 62(62.6%) 33(32.4%) Other 6(6.1%) 16(15.7%) Guidewires 0.018 0 5(3.8%) 0.016 10(11.5%) 28(21.5%) 0.014 11(12.6%) 34(26.2%) 0.010 51(58.6%) 41(31.5%) Note.—n-BCA indicates n-bytyl cyanoacrylate; PVA, polyvinyl alcohol.
* P < .0001.
** 95 coils used in one patient.
n-BCA PVA Number of patients transfused 13 13 Number of units transfused (mean, median, range) 51 (3.4, 2, 1–16) 135 (10.4, 3,1–61) Fluid, colloid replacement (cc) 3918 4053 Surgery min (mean) 381 (n = 41) 413 (n = 42) Note.—n-BCA indicates n-butyl cyanoacrylate; PVA, polyvinyl alcohol.
Complications n-BCA (n = 54) PVA (n = 52) Seizure 5(9.3%) 5(9.6%) Catheter glued inside vessel 4(7.4%) 0(0.0%) Late polymerization 3(5.6%) 0(0.0%) Occluded catheter 3(5.6%) 5(9.6%) Parenchymal hemorrhage 3(5.6%) 6(11.5%) Vasospasm 3(5.6%) 7(13.5%) AVM rupture 2(3.7%) 1(1.9%) Early polymerization 2(3.7%) 0(0.0%) Inability to subselect vessel 2(3.7%) 4(7.7%) CVA (stroke) 2(3.7%) 3(5.8%) Death 1(1.9%) 3(5.8%) Hematoma 1(1.9%) 1(1.9%) Incorrect vessel(s) occluded 1(1.9%) 0(0.0%) Infection/inflammation 1(1.9%) 0(0.0%) Over-the-wire system could not be advanced 1(1.9%) 1(1.9%) Thromboembolism 1(1.9%) 1(1.9%) Vessel dissection 1(1.9%) 1(1.9%) Vessel perforation 1(1.9%) 3(5.8%) Cranial ischemia (TIA) 0(0.0%) 2(3.8%) Catheter rupture 0(0.0%) 1(1.9%) Failure to access vessel 0(0.0%) 2(3.8%) Flow too high for safe infusion of embolic agent 0(0.0%) 2(3.8%) Headache 0(0.0%) 2(3.8%) Pulmonary embolism 0(0.0%) 1(1.9%) Subarachnoid hemorrhage 0(0.0%) 2(3.8%) Provocative test failed 0(0.0%) 1(1.9%) Uncooperative patient 0(0.0%) 2(3.8%) Other 9(16.7%) 9(17.3%) Note.—n-BCA indicates n-butyl cyanoacrylate; PVA, polyvinyl alcohol; AVM, arteriovenous malformation; CVA, cerebrovascular accident; TIA, transient ischemic attack.
n-BCA (n = 54) PVA (n = 52) Total hemorrhagic complications 7(13.0%) 15(28.9%) Vessel perforation, SAH* using 3- or 1.9-French OTW catheter 1(1.9%) 3(5.8%) Vessel perforation, SAH* using flow-guided catheter only 0 1(1.9%) Postembolization, presurgical intracerebral hemorrhage 4(7.4%) 3(5.8%) Postoperative hemorrhage 2(3.7%)** 8(15.4%)** AVM volume cm3 mean (range) 21.8(10.4–32.4) 20.2(6.3–105.3) Deep venous drainage (n) 2 6 Coils, mean, range 12, 0–24 17.4, 0–50 Note.—n-BCA indicates n-butyl cyanoacrylate; PVA, polyvinyl alcohol; SAH, subarachnoid hemorrhage; AVM, arteriovenous malformation.
* Subarachnoid hemorrhage identified on early postembolization CT scan; not identified at fluoroscopy.
** P < .05 in intent-to-treat analysis.
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