The influence of hemorrhage presentation on clinical outcomes of curative embolisation in 125 cerebellar arteriovenous malformations.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-08-01 Epub Date: 2021-12-09 DOI:10.1080/02688697.2021.2013436

Dong Liu, Shuai Zhang, Xiaowei Ma, Zhongjun Li, Huijian Ge, Yilong Wang, Ming Lv

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引用次数: 0

Abstract

Background: This study investigated the influence of periprocedural hemorrhage and clinical outcomes with an endovascular therapeutic strategy for cerebellar arteriovenous malformations (cAVMs).

Methods: From December 2006 to January 2018, 125 cAVMs were classified as types I-IV and received endovascular embolization via Onyx or Glubran 2. The risk factors of hemorrhage were analyzed using univariate and multivariate logistic analyses. A modified Rankin Scale (mRS) score was used to evaluate the neurological function before and 1 year after the operation. Results Of 125 patients, 63 had type I cAVMs, 2 type II cAVMs, 48 type III cAVMs, and 12 type IV cAVMs. A total of 88 (70.4%) patients had clinical manifestations of intracranial hemorrhage. Multivariate logistic regression analysis showed that age (OR, 2.276; 95% CI, 1.132 - 5.663), flow-related aneurysm (OR, 2.845; 95% CI, 1.265 - 6.248), lesion size (OR, 3.005; 95% CI, 1.119 - 5.936), and the number of feeding arteries (OR, 0.105; 95% CI, 0.081 - 0.312) were still the significant independent risk factors of intracranial hemorrhage. During a 1-year follow-up, 109 patients (87.2%) had good outcomes (mRS 0 - 2), 12 patients (9.6%) had poor outcomes (mRS 3 - 4), 4 patients (3.2%) died, and 3 patients had intracranial hemorrhage due to the incomplete embolization of cAVMs.

Conclusions: Endovascular embolization is a feasible treatment for cAVMs. Age, flow-related aneurysm, lesion size, and the number of feeding arteries are the significant risk factors of periprocedural hemorrhage. Moreover, the lesion characteristics must be given full consideration when using Onyx or Glubran 2 before cAVMs embolization.

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出血表现对 125 例小脑动静脉畸形治愈性栓塞术临床疗效的影响。

背景：本研究探讨了小脑动静脉畸形（cAVMs）的血管内治疗策略对术中出血和临床结果的影响：该研究探讨了小脑动静脉畸形（cAVMs）的血管内治疗策略对术周出血和临床预后的影响：2006年12月至2018年1月，125例小脑动静脉畸形被分类为I-IV型，并接受了Onyx或Glubran 2血管内栓塞治疗。改良Rankin量表（mRS）评分用于评估术前和术后1年的神经功能。结果 125例患者中，63例为I型cAVM，2例为II型cAVM，48例为III型cAVM，12例为IV型cAVM。共有 88 例（70.4%）患者有颅内出血的临床表现。多变量逻辑回归分析显示，年龄（OR，2.276；95% CI，1.132 - 5.663）、血流相关动脉瘤（OR，2.845；95% CI，1.265 - 6.248）、病变大小（OR，3.005；95% CI，1.119 - 5.936）和供血动脉数量（OR，0.105；95% CI，0.081 - 0.312）仍是颅内出血的重要独立危险因素。在为期1年的随访中，109名患者（87.2%）疗效良好（mRS 0 - 2），12名患者（9.6%）疗效不佳（mRS 3 - 4），4名患者（3.2%）死亡，3名患者因cAVM栓塞不完全而导致颅内出血：结论：血管内栓塞是一种可行的cAVM治疗方法。年龄、血流相关动脉瘤、病变大小和供血动脉数量是围手术期出血的重要风险因素。此外，在使用Onyx或Glubran 2栓塞cAVMs前，必须充分考虑病变特征。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.