BLOOD-PRESSURE MONITORING IN FEEDING ARTERIES OF CEREBRAL ARTERIOVENOUS-MALFORMATIONS DURING EMBOLIZATION - A PREVENTIVE ROLE IN HEMODYNAMIC COMPLICATIONS

TO STUDY THE hemodynamics of arteriovenous malformations and to avoid hemodynamic complications during and after artificial embolization, we measured arterial blood pressures in 21 feeders in 14 patients throug h a microcatheter system. Before embolization, the pressures were sign ificantly low in feeders with branches terminating in the malformation (terminal divided branches) and comparatively low in arteriovenous ma lformations with rapid blood flow through the malformation. The pressu res in feeders with brain-nutrifying branches distal to the nidus (tra nsient branches) were significantly high. Therefore, transient branche s might be distinguishable from terminal divided branches with the use of feeder pressure monitoring. A hemorrhagic complication occurred in one patient. The feeder pressure in this patient was low before embol ization and showed the maximum change among the patients after emboliz ation. It seems that the lower the feeder pressure, the more likely co mplications are to occur, owing to remarkable hemodynamic alterations. Feeder pressure monitoring may be useful for preventing hemodynamic c omplications, especially when angiographic findings show feeding arter ies giving off terminal divided or transient branches or rapid blood f low through the malformation.