Microsurgical resection of previously embolized recurrent cerebellopontine angle AVM

Neurosurg Focus Video. 2021 Jan 1;4(1):V2. doi: 10.3171/2020.10.FOCVID2057. eCollection 2021 Jan.

Abstract

This is the case of a ruptured Spetzler-Martin grade II arteriovenous malformation (AVM) located in the cerebellopontine angle and draining into the transverse sinus. The AVM was initially treated with staged embolization using Onyx (ev3 Neurovascular). However, recurrence was noted and treatment with microsurgical resection was undertaken. The authors present technical nuances of the approach and strategies for microsurgical resection of a previously embolized recurrent AVM with the aid of intraoperative indocyanine green angiography. Follow-up after endovascular treatment is critical, and curative treatment with microsurgical resection can be achieved with low morbidity in such AVMs as demonstrated by this case. The video can be found here: https://youtu.be/LMpz_YTFC0g.

Keywords: Onyx; arteriovenous malformation; embolization; microsurgical resection; recurrence.