OUTCOME ANALYSIS OF PREOPERATIVE EMBOLIZATION WITH N-BUTYL CYANOACRYLATE IN CEREBRAL ARTERIOVENOUS-MALFORMATIONS

PURPOSE: To determine the influence of preoperative N-butyl cyanoacryl ate embolization on outcome in the treatment of cerebral arteriovenous malformations. METHODS: Two groups were compared: 30 patients who und erwent surgery and embolization versus 41 patients who underwent surge ry only. Both groups were categorized by Spetzler-Martin grade and eva luated with the Glasgow Outcome Scale at various intervals. The long-t erm follow-up in months was, for surgery only, mean of 35 and range of 4 to 59, and for surgery and embolization, mean of 10 and range of 1 to 19). RESULTS: The arteriovenous malformations in the surgery and em bolization group had a larger average greatest diameter (4.2 +/- 1.5 c m versus 3.4 +/- 1.8 cm) and were of higher Spetzler-Martin grade (89% versus 68% grade III-V). No significant difference in the preoperativ e or immediate postoperative (less than 24 hours) Glasgow Outcome Scal e was identified between the two groups, At 1 week after surgery, the surgery and embolization group displayed a significantly better outcom e evaluation (70% versus 41% with Glasgow Outcome Scale score of 5). T he long-term evaluation continued to favor the surgery and embolizatio n patients (86% versus 66% with Glasgow Outcome Scale score of 5). CON CLUSION: Preoperative N-butyl cyanoacrylate embolization improves post surgical outcome.