Endovascular embolization of cerebral arteriovenous malformations: results of the Japanese Registry of Neuroendovascular Therapy (JR-NET) 1 and 2

Neurol Med Chir (Tokyo). 2014;54(1):54-62. doi: 10.2176/nmc.oa2013-0183. Epub 2013 Nov 29.

Abstract

This retrospective study constitutes a part of the Japanese Registry of Neuroendovascular Therapy (JR-NET) 1 and 2. Its purpose is to evaluate the feasibility, safety, and outcome of endovascular embolization for cerebral arteriovenous malformations (AVMs) in Japan. Nine hundred and eighty-seven embolization procedures were registered with JR-NET 1 and 2 (424 procedures in 122 institutions with JRNET 1 and 563 procedures in 150 institutions with JRNET 2). In total, 790 patients (80.1%) had favourable clinical outcomes defined as modified Rankin Scale (mRS) scores 0-2 at 30 days after embolization. Complete AVM obliteration by embolization alone was achieved in 90 procedures (9.1%). The procedural morbidity and mortality rate was 2.5% and 0.3% per procedure, respectively. In the multivariate logistic regression models, deep venous drainage and embolization of four or more feeding pedicles per session were significantly associated with any treatment-related complications (P = 0.02 and P = 0.003, respectively). About 6 cm or more in maximum nidus diameter had a negative correlation with complications (P = 0.003). Our study shows that embolization of cerebral AVMs was performed with a high degree of safety and a low rate of symptomatic complications in Japan.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers
  • Cerebral Hemorrhage / etiology
  • Child
  • Child, Preschool
  • Dimethyl Sulfoxide / therapeutic use
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / methods
  • Embolization, Therapeutic / statistics & numerical data*
  • Endovascular Procedures / statistics & numerical data
  • Female
  • Health Care Surveys
  • Humans
  • Infant
  • Infant, Newborn
  • Intracranial Arteriovenous Malformations / complications
  • Intracranial Arteriovenous Malformations / therapy*
  • Japan
  • Male
  • Middle Aged
  • Neurosurgical Procedures / statistics & numerical data
  • Polyvinyls / therapeutic use
  • Registries
  • Retrospective Studies
  • Young Adult

Substances

  • Biomarkers
  • Onyx copolymer
  • Polyvinyls
  • Dimethyl Sulfoxide