Endovascular treatment of aneurysms associated with cerebral arteriovenousmalformations: experiences after the introduction of Guglielmi detachable coils

The authors have treated 172 patients with arteriovenous malformation (AVM) since 1993. Among them, 25 patients had aneurysms with a total number of 4 3. The aneurysms were divided into four groups; proper feeder aneurysm (4), flow-related distal aneurysm (beyond the circle of Willis or M1, 7), flaw- related proximal aneurysm (26) and remote aneurysm (6). Guglielmi detachabl e coil (GDC) embolisation was performed in 12 patients with 15 aneurysms. G amma knife radiosurgery for AVM was performed in 10 of those 12 patients. T wo of the proper feeder aneurysms were embolised with liquid material, toge ther with the corresponding part of the AVM. The other aneurysms were treat ed surgically (14) or observed (12). There was no bleeding from aneurysms a fter treatment, in conclusion, GDC embolisation is a useful treatment for a neurysms associated with AVM, especially if the AVM is treated by radiosurg ery, Liquid embolisation of a proper feeder aneurysm is one of the treatmen t options. (C) 2000 Harcourt Publishers Ltd.