Complications of embolization of arteriovenous malformations of the brain

Charles S. Haw M.D., F.R.C.S.(C) 1 , Karel terBrugge M.D., F.R.C.P.(C) 1 , Robert Willinsky M.D., F.R.C.P.(C) 1 , and George Tomlinson Ph.D. 1
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  • 1 Division of Neurosurgery, Vancouver General Hospital, University of British Columbia, Vancouver; Department of Medical Imaging, The Toronto Western Hospital, The Brain Vascular Malformation Study Group, University of Toronto; and Department of Medicine, Biostatistics, Toronto General Hospital Research Institute, University of Toronto, Ontario, Canada
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Object

The goal of this study was to determine the rates of mortality and morbidity associated with the embolization of arteriovenous malformations (AVMs) of the brain and to analyze the factors related to embolization-related complications.

Methods

The University of Toronto Brain Vascular Malformation Study Group database was reviewed. Three hundred six patients underwent 513 embolization sessions between November 1984 and September 2002. The combined rate of death and any permanent disabling neurological deficit was 3.9% per patient. Location of the AVM in an eloquent part of the brain, presence of a fistula, and a venous deposition of glue were related to complications. A clinically important reduction in the rate of death and disabling morbidity occurred in the second half of the study period.

Conclusions

Embolization of AVMs in the brain is associated with low overall rates of mortality and disabling morbidity.

Abbreviations used in this paper: AVF = arteriovenous fistula; AVM = arteriovenous malformation; CA = carotid artery; GEE = generalized estimating equation; mRS = modified Rankin Scale.

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Contributor Notes

Address reprint requests to: Charles S. Haw, M.D., F.R.C.S.(C), Suite C305, 700 West 10th Avenue, Vancouver, British Columbia V5Z-4E5, Canada. email: basilartip@telus.net.
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