Article Figures & Data
Figures
- Fig 1.
Right posterior temporal BAVM treated in single-session procedure.
A and B, Initial angiogram showing the nidus and the cortical drainage veins in anteroposterior (AP) and lateral views.
C, Selective angiogram in AP view showing the microcatheterization with an intranidal position of the microcatheter tip (arrowhead), the nidal network (arrow), and one of the draining veins (white arrow).
D and E, Nonsubtracted images in AP and lateral view showing the Onyx cast with some degree of reflux into the arterial feeder (arrow) and the draining vein filled by the embolic agent (white arrows).
F and G, Final angiogram in AP and lateral views demonstrating the total occlusion of the BAVM.
- Fig 2.
Large left frontal BAVM treated in staged sessions.
A and B, Initial angiogram in anteroposterior (AP) and lateral views showing various arterial feeders allowing for nidal catheterization. To reduce periprocedural or postprocedural ischemic or hemorrhagic complications, the BAVM was gradually occluded in 3 sessions.
C and D, Nonsubtracted images in AP and lateral views showing the extensive Onyx cast.
E and F, Final angiographic control demonstrating total BAVM occlusion.
Tables
Grade Patients [% (n)] I 4.5 (4) II 37 (35) III 40.5 (38) IV 17 (16) V 1 (1) Total 100 (94) Anatomic Locations No. Hemispheric Cortical Dominant hemisphere 38 Nondominant hemisphere 35 Deep Dominant hemisphere 6 Nondominant hemisphere 4 Corpus callosum 2 Cerebellum Vermis 3 Hemispheric 4 Quadrigeminal plate 2 Total 94 Nidus Size Patients [% (n)] <2 cm 13 (12) 2–<4 cm 48 (45) ≥4 cm 39 (37) Total 100 (94) - Table 4:
Permanent neurological treatment-related complications and death among the 94 patients
Patient No BAVM Locations Causative Agent Complications Complication Type Outcome (mRS) 1 Left subthalamus Onyx Ophthalmoplegia Ischemic 1 2 Quadrigeminal plate Onyx/n-BCA Transient diplopia Hemorrhagic 1 3 Right internal capsule n-BCA Left hemiparesis Hemorrhagic 3 4 Left frontal lobe Onyx Transient right hemiparesis Hemorrhagic 3 5 Right temporal lobe n-BCA Hemianopsia Ischemic 1 6 Right temporal lobe n-BCA Left hemiparesis Hemorrhagic 3 7 Right temporal lobe n-BCA Transient left hemiparesis Hemorrhagic 3 8 Right temporal lobe n-BCA Left hemiparesis Ischemic 2 9 Right temporal lobe Surgery Death Hemorrhagic 6 10 Cerebellar vermis n-BCA Death Hemorrhagic 6 11 Left thalamus Catheterization Death Hemorrhagic 6 Overall complications % (n) Neurologic complications 12% (11) Deaths 3% (3) Onyx-induced complications % (n) Neurologic complications 3% (3) Deaths 0 (0) Note:—BAVM indicates brain arteriovenous malformation; mRS, modified Rankin scale; n-BCA, n-butyl cyanoacrylate
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