Endovascular treatment of aneurysms associated with cerebral arteriovenous malformations

Rozhchenko L.V.

Prof. A.L. Polenov Russian Research Institute of Neurosurgery — Branch, V.A. Almazov National Medical Research Center of the Ministry of Health of Russia

Petrov A.E.

Prof. A.L. Polenov Russian Research Institute of Neurosurgery — Branch, V.A. Almazov National Medical Research Center of the Ministry of Health of Russia

Goroshchenko S.A.

Prof. A.L. Polenov Russian Research Institute of Neurosurgery — Branch, V.A. Almazov National Medical Research Center of the Ministry of Health of Russia

Bobinov V.V.

Polenov Neurosurgery Institute

Samochernykh K.A.

Almazov National Medical Research Centre, Polenov Neurosurgery Research Institute

ORCID: 0000-0001-5295-4912

Endovascular treatment of aneurysms associated with cerebral arteriovenous malformations

Authors:

Rozhchenko L.V., Petrov A.E., Goroshchenko S.A., Bobinov V.V., Samochernykh K.A.

More about the authors

Journal: Burdenko's Journal of Neurosurgery. 2022;86(2): 25‑35

DOI: 10.17116/neiro20228602125

Downloaded: 84

To cite this article:

Rozhchenko LV, Petrov AE, Goroshchenko SA, Bobinov VV, Samochernykh KA. Endovascular treatment of aneurysms associated with cerebral arteriovenous malformations. Burdenko's Journal of Neurosurgery. 2022;86(2):25‑35. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20228602125

Подписка 2025-2 (Burdenko's Journal of Neurosurgery)

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OBJECTIVE

To evaluate treatment outcomes in 120 patients with AVM-associated aneurysms.

MATERIAL AND METHODS

We analyzed treatment outcomes in 639 patients with cerebral AVM who underwent 1992 endovascular procedures between 2010 and 2019. AVM-associated aneurysms were found in 120 (18.8%) cases: 81 (67.5%) patients with 69 proximal and 29 distal aneurysms, 33 (27.5%) AVMs with intranidal aneurysms and 6 (5%) aneurysms without hemodynamic connection with AVM. One hundred and one malformations (16.9%) out of 596 supratentorial AVMs and 19 (44.2%) out of 43 subtentorial AVMs were associated with aneurysms.

RESULTS

Intracranial hemorrhage occurred in 349 (53.3%) out of 639 patients with AVM: 97 (80.8%) out of 120 patients with AVM-associated aneurysms and 252 (48.6%) out of 519 ones with AVM and no aneurysms. All 33 patients with intranidal aneurysms in the AVM structure and 18 (94.7%) out of 19 patients with AVM-associated aneurysms and AVM in posterior cranial fossa had intracranial hemorrhage. There were 98 aneurysms in 81 patients with AVM-associated aneurysms. Eighty-nine (90.8%) ones underwent endovascular treatment, 6 (6.1%) patients with proximal aneurysms required microsurgery. Three distal aneurysms were not repaired. Thirty-four aneurysms were embolized with spirals. Embolization with spirals and balloon assistance was performed for 41 aneurysms, spirals with stent-assistance — for 9 aneurysms (including 1 distal MCA aneurysm in hemorrhagic period). Implantation of a flow-diverting stent was performed for 5 aneurysms (1 distal and 4 proximal aneurysms). There were 8 (8.9%) complications after embolization of 89 AVM-associated aneurysms (5 thromboembolic and 3 hemorrhagic events).

CONCLUSION

According to our data, intranidal aneurysms require exclusion of the parent AVM segment due to high risk of hemorrhage. Treatment of proximal AVM-associated aneurysms should be carried out prior to AVM embolization. Distal aneurysms do not regress after definitive AVM treatment and should be operated on after total AVM embolization.

Keywords:

arteriovenous malformation

AVM-associated aneurysm

aneurysm embolization

Authors:

Rozhchenko L.V.

Prof. A.L. Polenov Russian Research Institute of Neurosurgery — Branch, V.A. Almazov National Medical Research Center of the Ministry of Health of Russia

Petrov A.E.

Prof. A.L. Polenov Russian Research Institute of Neurosurgery — Branch, V.A. Almazov National Medical Research Center of the Ministry of Health of Russia

Goroshchenko S.A.

Prof. A.L. Polenov Russian Research Institute of Neurosurgery — Branch, V.A. Almazov National Medical Research Center of the Ministry of Health of Russia

Bobinov V.V.

Polenov Neurosurgery Institute

Samochernykh K.A.

Almazov National Medical Research Centre, Polenov Neurosurgery Research Institute

ORCID: 0000-0001-5295-4912

Received:

10.11.2020

Accepted:

28.01.2022

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