Curative treatment of cerebral arteriovenous malformations by embolisationusing cellulose acetate polymer followed by surgical resection

To investigate the usefulness of embolising cerebral arteriovenous malforma tions (AVMs) with a cellulose acetate polymer solution before surgical rese ction. Methods: The cases of 12 patients with AVMs treated by embolisation before surgical resection were renewed. Two types of cellulose acetate polymer sol utions were used to occlude 40 feeding vessels. All patients underwent surg ical resection 1-51 days after embolisation. Results: Reduction of the nidus volume after embolisation ranged from 20% t o nearly 100%. Transient neurological deficits occurred in three patients, persistent deficits occurred in one and there were no haemorrhagic complica tions. All but one arteriovenous malformation were completely resected, Emb olisation helped to identify feeding vessels and ease dissection. Histopath ological examination of resected specimens disclosed mild inflammatory reac tions in the acute stage and no unfavourable granulomatous changes in the c hronic stage. Conclusion: Embolisation with cellulose acetate polymer solutions followed by surgical resection is safe and efficacious for treating cerebral AVMs. ( C) 2000 Harcourt Publishers Ltd.