TY  - BOOK
AU  - Armonda, Rocco A
AU  - Bank, William O
AU  - Bell, Randy S
AU  - Liu, Ai-Hsi
AU  - Stemer, Andrew B
TI  - Acute embolization of ruptured brain arteriovenous malformations
SN  - 1759-8478
PY  - 2013///
KW  - *Arteriovenous Fistula/ra [Radiography]
KW  - *Arteriovenous Fistula/th [Therapy]
KW  - *Embolization, Therapeutic/mt [Methods]
KW  - *Intracranial Arteriovenous Malformations/ra [Radiography]
KW  - *Intracranial Arteriovenous Malformations/th [Therapy]
KW  - Adolescent
KW  - Adult
KW  - Aged
KW  - Child
KW  - Female
KW  - Follow-Up Studies
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Prospective Studies
KW  - Retrospective Studies
KW  - Time Factors
KW  - Young Adult
KW  - MedStar Washington Hospital Center
KW  - Radiology
KW  - Journal Article
N1  - Available online through MWHC library: 2009 - present
N2  - BACKGROUND: Ruptured brain arteriovenous malformations (bAVMs) are at increased risk of re-hemorrhage but management has historically been conservative. This is because: (1) ruptured bAVMs have not been considered as catastrophic as ruptured cerebral aneurysms, (2) surgical resection is aided by waiting for brain edema to resolve and clot to liquefy and (3) fear exists that partially treated bAVMs may be more dangerous than those untreated. The purpose of this study was to determine the feasibility and safety of acute embolization in patients with ruptured bAVMs; CONCLUSION: Treatment of ruptured bAVMs is often delayed but our experience with Onyx suggests that acute embolization is safe and feasible; METHODS: 21 consecutive patients who underwent acute embolization of ruptured bAVMs from 2007 to 2011 were retrospectively reviewed. All treatments consisted of embolization exclusively using Onyx liquid embolic agent. Neurological outcomes were assessed using the Glasgow Outcome Scale (GOS) at hospital discharge following initial treatment; RESULTS: Nine patients (43%) were male, mean age was 38 years (range 8-75) and initial embolization was performed at a median of 4 days after ictus (mean 5.8, range 0-19). Spetzler-Martin grades ranged from I to VI (mean 3, median 3). In seven patients (33%) the AVM was completely occluded with a single treatment. With subsequent embolizations, complete occlusion occurred in four additional patients (19%). Six patients (29%) had post-embolization AVM resection and one patient (5%) had post-embolization gamma knife irradiation. None has suffered subsequent hemorrhages (mean follow-up 7.5 months). The mean discharge GOS of all patients was 4.4 (range 1-5)
UR  - http://dx.doi.org/10.1136/neurintsurg-2011-010214
ER  -