Percutaneous n-butyl cyanoacrylate glue embolization combined with arterial embolization for extracranial arteriovenous malformations.

Objectives: Congenital arteriovenous malformations (AVMs) are characterized by abnormal connections between arteries and veins, often presenting challenges in treatment due to their complex vascular structure. Endovascular therapies, including embolization techniques, have become integral in managing AVMs, yet optimal treatment strategies remain under investigation. This retrospective study aimed to evaluate the safety and efficacy of percutaneous glue embolization of n-butyl cyanoacrylate (nBCA) combined with arterial embolization in treating extracranial AVMs.

Material and methods: This retrospective study included 11 patients with extracranial AVMs who underwent percutaneous injection of nBCA glue embolization combined with arterial embolization at our institution between May 2015 and October 2023. Angiographic classification was performed using the Cho-Do vascular imaging system and the Schobinger classification system to categorize the AVMs. Treatment efficacy was assessed based on the percentage of vessel occlusion observed in angiography or imaging studies. The occurrence of major and minor complications was also evaluated.

Results: Eleven patients received 16 treatments, involving a combination of arterial and percutaneous embolization techniques. Five cases achieved complete recovery, while four cases showed significant improvement, resulting in an overall treatment success rate of 81.8%. Favorable outcomes were observed in terms of symptom alleviation and lesion occlusion. Adverse events were minimal, with transient pain and edema being the most common postoperative complaints. Only one case of mild post-operative complication occurred.

Conclusion: Percutaneous glue embolization combined with arterial embolization proves to be a safe and effective treatment modality for extracranial AVMs, with acceptable rates of complications and favorable treatment outcomes.