Angioarchitectural Characteristics Associated with Complications of Embolization in Supratentorial Brain Arteriovenous Malformation

Article Figures & Data

Table 1:

Demographic and clinical characteristics of 130 patients with sbAVM embolization

Table 2:

Preprocedual angioarchitectural characteristics of 130 patients with sbAVM embolization

Angiographic Features	No. (%)
Location
Eloquent cortex	44 (33.85%)
Noneloquent cortex	62 (47.69%)
Midline	12 (9.23%)
Deep	12 (9.23%)
Size
≤3 cm	32 (24.62%)
3–6 cm	80 (61.54%)
≥6 cm	18 (13.85%)
No. of feeders
1	17 (13.08%)
2	28 (21.54%)
≥3	85 (65.38%)
Arterial feeders classification
Terminal	95 (73.08%)
Perforating	35 (26.92%)
No. of draining veins
1	55 (42.31%)
2	37 (28.46%)
≥3	38 (29.23%)
Venous drainage classification
Exclusive superficial	79 (60.77%)
Exclusive deep	16 (12.31%)
Combined	35 (26.92%)
Venous morphology
Venous reflux	35 (26.92%)
Venous ectasia	29 (22.31%)
Venous stenosis	46 (35.38%)
Coexisting aneurysm
Intranidal	30 (23.08%)
Perinidal	7 (5.38%)
Spetzler-Martin classification
I–II	50 (38.46%)
III	36 (27.69%)
IV	30 (23.08%)
V	14 (10.77%)

Table 5:

Demographic, clinical, and angioarchitectural characteristics predictive for embolization complications by univariate analysis

Characteristics	OR (95% CI)	P Value
Sex
Male	0.84 (0.33–2.10)	.75
Age, y
<18	0.89 (0.31–2.41)	.78
18–49	1.09 (0.37–2.76)	.84
≥50	1.16 (0.17–11.36)	1.01
Initial presentation
Hemorrhage	1.15 (0.59–2.94)	.49
Ischemia	0.65 (0.14–3.27)	1.00
Headache	1.86 (0.93–5.63)	.57
Seizures	0.64 (0.37–2.00)	.55
No symptoms	0.91 (0.17–4.39)	.70
Location
Eloquent cortex	2.57 (1.08–3.42)	.02
Noneloquent cortex	0.38 (0.24–0.86)	.02
Midline	0.55 (0.19–2.42)	.79
Deep	1.41 (0.29–2.85)	.51
Size
≤3 cm	1.06 (0.42–2.40)	.79
3–6 cm	0.80 (0.33–1.29)	.23
≥6 cm	2.45 (0.57–5.32)	.17
No. of feeders
1	0.39 (0.06–1.54)	.38
2	1.75 (0.76–3.21)	.26
≥3	0.85 (0.47–3.84)	.72
Classification of feeders
Terminal	0.61 (0.35–1.97)	.32
Perforating	1.64 (0.79–4.58)	.25
No. of draining veins
1	0.73 (0.43–2.96)	.98
2	1.57 (0.58–3.63)	.34
≥3	0.62 (0.34–1.89)	.43
Drainage classification
Exclusive superficial	1.04 (0.77–2.52)	.90
Exclusive deep	4.56 (1.28–9.67)	.00
Combined	0.24 (0.09–0.53)	.03
Venous morphology
Venous reflux	1.91 (0.51–2.98)	.77
Venous ectasia	2.24 (1.32–9.88)	.26
Venous stenosis	1.50 (0.26–2.34)	.19
Coexisting aneurysm
Intranidal	0.99 (0.23–3.81)	.22
Perinidal	1.52 (3.72–8.50)	.61
Spetzler-Martin classification
I–II	2.32 (0.21–9.87)	.48
III	0.58 (0.70–4.05)	.54
IV	1.61 (1.22–4.53)	1.20
V	0.83 (0.06–10.29)	1.00
Embolization degree
Complete	0.87 (0.27–3.02)	.27
Subtotal	0.71 (0.40–1.60)	.13
Partial	1.92 (1.21–4.07)	.17
Venous occlusion	1.26 (0.94–2.83)	.84

Table 6:

Spetzler-Martin classification and mRS score before and after embolization in 130 patients with sbAVMs

Grade	Preprocedural, No. (%)	Postprocedural, No. (%)
Spetzler-Martin classification
I	16 (16.31%)	34 (33.33%)^a
II	34 (26.15%)	20 (19.61%)
III	36 (27.69%)	28 (27.45%)
IV	30 (23.08%)	16 (15.69%)
V	14 (10.77%)	4 (3.92%)
mRS
0	10 (7.69%)	29 (22.31%)^a
1	79 (60.77%)	54 (41.54%)^a
2	19 (14.62%)	20 (15.38%)
3	11 (8.46%)	11 (8.46%)
4	5 (3.85%)	12 (9.23%)
5	6 (4.62%)	3 (2.31%)
6	0 (0%)	1 (0.77%)

Table 7:

Embolization complications by n-BCA and/or Onyx according to the literature (11 series)

Series [Reference]	Patients	Materials	Complication, %	PND, %	Mortality, %
Taylor et al [2]	201	n-BCA/Onyx	21	11	2
Van Rooij et al [4]	44	Onyx	13.8	4.6	2.3
Katsaridis et al [5]	101	Onyx	14.9	7.9	2.9
Ledezma et al [7]	168	n-BCA	16.1	6.5	1.2
Haw et al [8]	306	n-BCA	6.4	3.9	0
Panagiotopoulos et al [11]	82	Onyx	19.5	3.8	2.4
Jayaraman et al [19]	192	n-BCA/Onyx	15.7	1.6	0
Starke et al [20]	275	n-BCA	14	2.5	0
Hauck et al [21]	107	Onyx	17	12.2	0
Velat et al [22]	88	n-BCA/Onyx	13.6	4.5	2.2
Present study	130	Onyx	17.7	6.9	0.8