Endovascular Therapy in Posterior Fossa Brain Arteriovenous Malformations: A Clinical Study

Abstract

AIM: To assess posterior fossa brain arteriovenous malformation (PFbAVM) patients who received initial endovascular interventionto reduce the lesion size, as well as embolization for the obliteration of the lesions.MATERIAL and METHODS: This retrospective analysis included 16 patients (7 males and 9 females) with PFbAVMs who weretreated between 2010 and 2017 via surgery, endovascular techniques, or combinations of modalities. Patient demographic andclinical features, angiographic characteristics, treatment modalities, complications, and outcomes were analyzed.RESULTS: Six patients with cerebellar AVMs, 2 with brainstem AVMs, and 8 with cerebellar–brainstem AVMs were included in thisstudy. All patients were treated by endovascular embolization as initial or final treatment. Patient characteristics were assessed forall 16 patients; 7 (43.75%) presented with hemorrhage, and they were further treated by microsurgery because of residual niduses.Complete obliteration was obtained in all patients. Two patients had persistent neurological deficits. The outcome was measuredwith the modified Rankin scale (mRS). Serviceable outcome (mRS ≤ 2) was attained in 14 patients.CONCLUSION: Successful treatment of PFbAVMs depends on an integrated team of neurosurgeons, radiosurgeons, andendovascular neurosurgeons. In PFbAVMs, endovascular embolization as adjuvant or final treatment is useful and safe.