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  4. Endovascular treatment of posterior fossa arteriovenous malformations.
 
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Titre

Endovascular treatment of posterior fossa arteriovenous malformations.

Type
article
Institution
Externe
Périodique
Journal of Clinical Neuroscience  
Auteur(s)
Robert, T.
Auteure/Auteur
Blanc, R.
Auteure/Auteur
Ciccio, G.
Auteure/Auteur
Gilboa, B.
Auteure/Auteur
Fahed, R.
Auteure/Auteur
Boissonnet, H.
Auteure/Auteur
Redjem, H.
Auteure/Auteur
Pistocchi, S.
Auteure/Auteur
Bartolini, B.
Auteure/Auteur
Piotin, M.
Auteure/Auteur
Liens vers les personnes
Bartolini, Bruno  
Pistocchi, Silvia  
ISSN
1532-2653
Statut éditorial
Publié
Date de publication
2016-03
Volume
25
Première page
65
Dernière page/numéro d’article
68
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Infratentorial arteriovenous malformations (AVM) are rare, representing only 7-15% of cerebral AVM. The concentration of eloquent neurological structures and the high rate of bleeding presentation of AVM in this location complicate the management of such lesions. New therapeutic options, especially in endovascular therapy, have fundamentally modified the treatment strategy and also the outcome of posterior fossa AVM. Between 1999 and 2013, baseline, clinical and angiographic data of cerebral AVM were prospectively collected. We analyzed data from patients treated for a posterior fossa AVM, focusing on risk factors for bleeding, and clinical and angiographic outcomes. Sixty-nine patients (mean age 34 years, male to female ratio 2:1) were consecutively treated for an infratentorial AVM. Fifty-seven presented with hemorrhage, six with focal neurologic deficits, and the remaining six patients were diagnosed incidentally. The Spetzler-Martin grade was < 3 in 39 (56.5%) patients. Associated aneurysms were noted in 43.5% of patients. All patients were treated using endovascular procedures, associated with microsurgical resection in nine patients and with stereotactic radiosurgery in six. Mean follow-up was 28.5 months, with angiographic exclusion of the AVM in 72.5% of patients; 21.7% of patients presented a modified Rankin Score ⩾ 3 at follow-up. Endovascular embolization seems to be a secure approach for posterior fossa AVM although a large number of sessions are necessary to achieve complete obliteration. Multi-disciplinary discussion and management is crucial to obtain the best cure rate without increasing procedural risks.
Sujets

Adult

Aged

Embolization, Therape...

Endovascular Procedur...

Female

Humans

Intracranial Arteriov...

Male

Middle Aged

Radiosurgery/methods

Retrospective Studies...

Risk Factors

Treatment Outcome

PID Serval
serval:BIB_A678D0A4B8CC
DOI
10.1016/j.jocn.2015.05.051
PMID
26549679
Permalien
https://iris.unil.ch/handle/iris/159722
Date de création
2017-05-03T10:44:52.276Z
Date de création dans IRIS
2025-05-20T23:14:44Z
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