The Study Of Clinical Outcom Of Cerebral Arteriovenous Malformation Embolization With NBCA And ONYX

Objective:To determine the safety and effectiveness of arteriovenous malformation (AVM)embolization in a series of 50 patients with cerebral AVMs who underwent embolization with N-butyl cyanoacrylate (NBCA) and ONYXMethods: All embolization procedures were performed using NBCA and ONYX.One group (30 patients) received embolization with NBCA and the other group (20 patients) using ONYX, including 32 males and 18 females between January 1998 and December 2004. The mean age is 33.5 years old. To study different clinical outcome of tow groups,according to different size, type of supplying arteries,number of supplying arteries and type of draining veins. All the date were analyzed by using X~2-test,Ridit-test and Fisher's Exact Test(2-Tail),figures were made with SAS6.12.Result: For middle size, cortex feeders,many feeders and superficial drainage the rate of cerebral AVMs embolization with ONYX are higher than NBCA (P=0.0000) . No significant difference is found in symptom and presentation after treatment. (P>0.05) .For NBCA and ONYX, small AVM with fewer supplying arteries is more likely to be embolized completely. Conclusion:According to the results of this research,we can conclude: For middle size, cortex feeders,many feeders and superficial drainage the rate of cerebral AVM s embolization with ONYX are higher than NBCA.For basal ganglia and central parietal region's AVM,the different the rate of embolization between NBCA and ONYX needs further practise and long term follow-up study. Some AVM with very small supplying arteries are not suitable for embolization.Large,basal ganglia or central parietal region's AVM should be treated by embolization surgery and radiosurgery. The fundamental principles of AVM embolization havenot changed, with the primary objective being to reduce the nidus size before surgery or radiation therapy, and the development of alternative agents to the notoriously temperamental n-butyl-cyanoacrylate may facilitate this goal. Onyx are now being used to occlude AVMs in a more controlled fashion because of the nonadhesive properties of these compounds.Initial concerns regarding the toxicity of the solvent dimethyl sulfoxide have been successfully addressed. Whether use of these compounds will translate into improved cure rates with fewer complications awaits additional experience and long-term follow-up.