Intra operative embolization of unresectable cerebral arterio venous malformations occlusion attempt by a delayed polymerization mixture 2 cases

Deruty, R.; Lapras, C.; Bret, P.; Taboada, F.; Duthel, R.

Neurochirurgie 27(1): 5-14

1981


ISSN/ISBN: 0028-3770
Accession: 005739773

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Abstract
Two cases of unresectable intra-cranial arteriovenous malformation (AVM) are reported, treated by direct intra-operative embolization. A 50% mixture of butyl-2-cyano-acrylate and mono-iodo-stearate of ethyle (duroliopaque) was used after catheterization of some of the feeding cortical arteries. No intra-operative angiography was performed. The 1st patient, admitted after subarachnoid hemorrhage and presenting with a mild transient right hemiparesia and aphasia, showed evidence of a left temporal AVM with a left middle cerebral artery supply and contribution from the left cerebral posterior artery. The AVM was embolized with 3 cm3 of the mixture. A mild aphasia occurred after surgery and completely recovered after 2 wk. Roughly half of the AVM was occluded on the postoperative angiograms. The 2nd patient suffering from a long history of seizures had a huge right frontal AVM, with a right middle cerebral artery and right anterior cerebral artery supply, contribution from a right lenticulostriate artery, the left anterior cerebral artery and the right posterior cerebral artery. The AVM was embolized with 7 cm3 of the mixture. A complete palsy of the left upper limb occurred after surgery, with complete recovery after 2 wk. On the post-operative angiograms, 3/4 of the AVM was occluded.