Skip to main content
SpringerLink
Log in

The Role of Embolic Agents in Endovascular Treatment of Intracranial Arteriovenous Malformations and Tumors

  • Chapter
Minimally Invasive Neurosurgery

Abstract

Advances in microneurosurgery, neurocritical care, and endovascular techniques have greatly improved outcomes for patients with complex neurosurgical disorders. The neurosurgeons of today have become involved in the application of high-technology solutions and have welcomed contributions from other disciplines. Less invasive approaches resulting in improved patient outcomes have helped to shift the focus of neurosurgery toward minimally invasive procedures. Currently, this trend is reflected in all aspects of the specialty. One of the most influenced areas is neuroendovascular surgery. With improvement and broad application of refined microsurgery, skull base techniques, computerized surgical guidance, and new catheter technology and embolic agents, this field has advanced quickly, with an ever increasing safety and effectiveness profile.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Luessenhop AJ, Spence WT. Artificial embolization of cerebral arteries: report of use in a case of arteriovenous malformation. JAMA 1960;172:1153–1155.

    PubMed  CAS  Google Scholar 

  2. Jafar JJ, Davis AJ, Berenstein A, Choi IS, Kupersmith MJ. The effect of embolization with N-butyl cyanoacrylate prior to surgical resection of cerebral arteriovenous malformations. J Neurosurg 1993;78:60–69.

    PubMed  CAS  Google Scholar 

  3. de Oliveira E, Tedeschi H, Raso J. Comprehensive management of arteriovenous malformations. Neurol Res 1998;20:673–683.

    PubMed  Google Scholar 

  4. Batjer HH, Devous MD, Sr., Meyer YJ, Purdy PD, Samson DS. Cerebrovascular hemodynamics in arteriovenous malformation complicated by normal perfusion pressure breakthrough. Neurosurgery 1988;22:503–509.

    Article  PubMed  CAS  Google Scholar 

  5. Spetzler RF, Wilson CB, Weinstein P, Mehdorn M, Townsend J, Telles D. Normal perfusion pressure breakthrough theory. Clin Neurosurg 1978;25:651–672.

    PubMed  CAS  Google Scholar 

  6. Flickinger JC, Pollock BE, Kondziolka D, Lunsford LD. Adose-response analysis of arteriovenous malformation obliteration after radiosurgery. Int J Radiat Oncol Biol Phys 1996;36:873–879.

    Article  PubMed  CAS  Google Scholar 

  7. Gobin YP, Laurent A, Merienne L, et al. Treatment of brain arteriovenous malformations by embolization and radiosurgery. J Neurosurg 1996;85:19–28.

    PubMed  CAS  Google Scholar 

  8. Wikholm G, Lundqvist C, Svendsen P. The Goteberg cohort of embolized cerebral arteriovenous malformations: a 6-year follow-up. Neurosurgery 2001;49:799–806.

    Article  PubMed  CAS  Google Scholar 

  9. Batjer HH, Purdy PD, Giller CA, Samson DS. Evidence of redistribution of cerebral blood flow during treatment for an intracranial arteriovenous malformation. Neurosurgery 1989;25:599–605.

    Article  PubMed  CAS  Google Scholar 

  10. Han PP, Ponce FA, Spetzler RF. Intention-to-treat analysis of Spetzler-Martin grades IV and V arteriovenous malformations: natural history and treatment paradigm. J Neurosurg 2003;98:3–7.

    Article  PubMed  Google Scholar 

  11. Heros RC. Spetzler-Martin grades IV and V arteriovenous malformations. J Neurosurg 2003;98:1–2.

    PubMed  Google Scholar 

  12. Porstmann W, Wierny L, Warnke H, Gerstberger G, Romaniuk PA. Catheter closure of patent ductus arteriosus. 62 cases treated without thoracotomy. Radiol Clin North Am 1971;9:203–218.

    PubMed  CAS  Google Scholar 

  13. Standard SC, Guterman LR, Chavis TD, Hopkins LN. Delayed recanalization of a cerebral arteriovenous malformation following angiographic obliteration with polyvinyl alcohol embolization. Surg Neurol 1995;44:109–113.

    Article  PubMed  CAS  Google Scholar 

  14. Debrun GM, Aletich V, Ausman JI, Charbel F, Dujovny M. Embolization of the nidus of brain arteriovenous malformations with n-butyl cyanoacrylate. Neurosurgery 1997;40:112–121.

    Article  PubMed  CAS  Google Scholar 

  15. Jahan R, Murayama Y, Gobin YP, Duckwiler GR, Vinters HV, Vinuela F. Embolization of arteriovenous malformations with Onyx: clinicopathological experience in 23 patients. Neurosurgery 2001;48:984–997.

    Article  PubMed  CAS  Google Scholar 

  16. Sampei K, Hashimoto N, Kazekawa K, Tsukahara T, Iwata H, Takaichi S. Histological changes in brain tissue and vasculature after intracarotid infusion of organic solvents in rats. Neuroradiology 1996;38:291–294.

    Article  PubMed  CAS  Google Scholar 

  17. Chaloupka JC, Huddle DC, Alderman J, Fink S, Hammond R, Vinters HV. A reexamination of the angiotoxicity of superselective injection of DMSO in the swine rete embolization model. AJNR Am J Neuroradiol 1999;20:401–410.

    PubMed  CAS  Google Scholar 

  18. Akin ED, Perkins E, Ross IB. Surgical handling characteristics of an ethylene vinyl alcohol copolymer compared with N-butyl cyanoacrylate use for embolization of vessels in an arteriovenous malformation resection model in swine. J Neurosurg 2003;98:366–370.

    PubMed  CAS  Google Scholar 

  19. Kerber C, Connors J, III, Knox K. The behavior of a new liquid embolic agent, neuracryl M, in blood. AANS/CNS Section on Cerebrovascular Surgery and American Society of Interventional and Therapeutic Neuroradiology Meeting, Nashville, TN, 1999 (oral presentation).

    Google Scholar 

  20. Kerber CW, Wong W, Knox K, et al. Neuracryl M, a new liquid embolic agent: initial clinical results (abstract). J Neurosurg 2000;92:196.

    Google Scholar 

  21. Chopko BW, Kerber C, Wong W, Knox K, Krall R. Initial neuropathologic observations after treatment of a human arteriovenous malformation with a novel liquid embolic agent, neuracryl-M, American Association of Neurological Surgery/Congress of Neurological Surgeons Section on Cerebrovascular Surgery and American Society of Interventional and Therapeutic Neuroradiology Meeting, New Orleans, LA, 2000 (poster presentation).

    Google Scholar 

  22. Horton JA, Kerber CW. Lidocaine injection into external carotid branches: provocative test to preserve cranial nerve function in therapeutic embolization. AJNR Am J Neuroradiol 1986;7:105–108.

    PubMed  CAS  Google Scholar 

  23. Peters KR, Quisling RG, Gilmore R, Mickle P, Kuperus JH. Intraarterial use of sodium methohexital for provocative testing during brain embolotherapy. AJNR Am J Neuroradiol 1993;14:171–174.

    PubMed  CAS  Google Scholar 

  24. Fournier D, TerBrugge KG, Willinsky R, Lasjaunias P, Montanera W. Endovascular treatment of intracerebral arteriovenous malformations: experience in 49 cases. J Neurosurg 1991;75:228–233.

    PubMed  CAS  Google Scholar 

  25. Fox AJ, Pelz DM, Lee DH. Arteriovenous malformations of the brain: recent results of endovascular therapy. Radiology 1990;177:51–57.

    PubMed  CAS  Google Scholar 

  26. Vinuela F, Dion JE, Duckwiler G, et al. Combined endovascular embolization and surgery in the management of cerebral arteriovenous malformations: experience with 101 cases. J Neurosurg 1991;75:856–864.

    PubMed  CAS  Google Scholar 

  27. Bullard DE, Bigner SH, Bigner DD. Comparison of intravenous versus intracarotid therapy with 1,3-bis(2-chloroethyl)-1-nitrosourea in a rat brain tumor model. Cancer Res 1985;45:5240–5245.

    PubMed  CAS  Google Scholar 

  28. Chiras J. Intra-arterial chemotherapy for the central nervous system, in Interventional Neuroradiology, 1st ed. (Connors J, Wojak J, eds.), WB Saunders, Philadelphia, 1999, pp. 368–371.

    Google Scholar 

  29. Theron J, Villemure JG, Worthington C, Tyler JL. Superselective intracerebral chemotherapy of malignant tumours with BCNU. Neuroradiological considerations. Neuroradiology 1986;28:118–125.

    Article  PubMed  CAS  Google Scholar 

  30. Collins JM. Pharmacologic rationale for regional drug delivery. J Clin Oncol 1984;2: 498–504.

    PubMed  CAS  Google Scholar 

  31. Defer G, Fauchon F, Schaison M, Chiras J, Brunet P. Visual toxicity following intraarterial chemotherapy with hydroxyethyl-CNU in patients with malignant gliomas. A prospective study with statistical analysis. Neuroradiology 1991;33:432–437.

    Article  PubMed  CAS  Google Scholar 

  32. Shapiro WR, Green SB, Burger PC, et al. A randomized comparison of intraarterial versus intravenous BCNU, with or without intravenous 5-fluorouracil, for newly diagnosed patients with malignant glioma. J Neurosurg 1992;76:772–781.

    PubMed  CAS  Google Scholar 

  33. Stewart DJ, Grahovac Z, Russel NA, et al. Phase I study of intracarotid PCNU. J Neurooncol 1987;5:245–250.

    Article  PubMed  CAS  Google Scholar 

  34. Maiese K, Walker RW, Gargan R, Victor JD. Intra-arterial cisplatin-associated optic and otic toxicity. Arch Neurol 1992;49:83–86.

    PubMed  CAS  Google Scholar 

  35. Tfayli A, Hentschel P, Madajewicz S, et al. Toxicities related to intraarterial infusion of cisplatin and etoposide in patients with brain tumors. J Neurooncol 1999;42: 73–77.

    Article  PubMed  CAS  Google Scholar 

  36. Qureshi AI, Suri MF, Khan J, et al. Superselective intraarterial carboplatin for treatment of intracranial neoplasms: experience in 100 procedures. J Neurooncol 2001;51: 151–158.

    Article  PubMed  CAS  Google Scholar 

  37. Hopkins LN, Lanzino G, Guterman LR. Treating complex nervous system vascular disorders through a “needle stick”: origins, evolution, and future of neuroendovascular therapy. Neurosurgery 2001;48:463–475.

    Article  PubMed  CAS  Google Scholar 

  38. Choi IS, Tantivatana J. Neuroendovascular management of intracranial and spinal tumors. Neurosurg Clin N Am 2000;11:167–185.

    PubMed  CAS  Google Scholar 

  39. Standard SC, Hopkins LN. Principles of neuroendovascular intervention, in Endovascular Neurological Intervention (Maciunas RJ, ed.), The American Association of Neurological Surgeons, Park Ridge, IL, 1995, pp. 1–34.

    Google Scholar 

  40. Ahn HS, Kerber CW, Deeb ZL. Extra-to intracranial arterial anastomoses in therapeutic embolization: recognition and role. AJNR Am J Neuroradiol 1980;1:71–75.

    PubMed  CAS  Google Scholar 

  41. Jungreis CA. Skull-base tumors: ethanol embolization of the cavernous carotid artery. Radiology 1991;181:741–743.

    PubMed  CAS  Google Scholar 

  42. Casasco A, Herbreteau D, Houdart E, et al. Devascularization of craniofacial tumors by percutaneous tumor puncture. AJNR Am J Neuroradiol 1994;15:1233–1239.

    PubMed  CAS  Google Scholar 

  43. Casasco A, Houdart E, Biondi A, et al. Major complications of percutaneous embolization of skull-base tumors. AJNR Am J Neuroradiol 1999;20:179–181.

    PubMed  CAS  Google Scholar 

  44. Manelfe C, Lasjaunias P, Ruscalleda J. Preoperative embolization of intracranial meningiomas. AJNR Am J Neuroradiol 1986;7:963–972.

    PubMed  CAS  Google Scholar 

  45. Richter HP, Schachenmayr W. Preoperative embolization of intracranial meningiomas. Neurosurgery 1983;13:261–268.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery and Toshiba Stroke Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY

    Ricardo A. Hanel MD, Elad I. Levy MD, Lee R. Guterman PhD, MD & L. Nelson Hopkins MD

  2. Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL

    Bernard R. Bendok MD

  3. Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL

    Bernard R. Bendok MD

  4. Neurological Institute of Savannah, Savannah, GA

    Jay U. Howington MD

Authors
  1. Ricardo A. Hanel MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bernard R. Bendok MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jay U. Howington MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Elad I. Levy MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lee R. Guterman PhD, MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. L. Nelson Hopkins MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, The Children’s Hospital, Harvard Medical School, Boston, MA

    Mark R. Proctor MD  & Peter M. Black MD, PhD  & 

  2. Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA

    Peter M. Black MD, PhD

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Hanel, R.A., Bendok, B.R., Howington, J.U., Levy, E.I., Guterman, L.R., Nelson Hopkins, L. (2005). The Role of Embolic Agents in Endovascular Treatment of Intracranial Arteriovenous Malformations and Tumors. In: Proctor, M.R., Black, P.M. (eds) Minimally Invasive Neurosurgery. Humana Press. https://doi.org/10.1385/1-59259-899-4:187

Download citation

  • DOI: https://doi.org/10.1385/1-59259-899-4:187

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-147-9

  • Online ISBN: 978-1-59259-899-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation