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Application of the pressure cooker technique for transarterial embolization of brain arteriovenous malformations: Factors affecting obliteration and outcomes

OBJECTIVE: The typical pressure cooker technique (PCT) and several modifications with similar mechanisms have been introduced to enhance the embolization of brain arteriovenous malformations (bAVMs). This study aimed to assess the effectiveness of transarterial embolization of bAVMs with the PCT. ME...

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Autores principales: Lu, Dan, Li, Yuqian, Yang, Zijian, Zhao, Zhenwei, Fang, Wei, Chen, Lei, Ma, Tao, Wang, Naibing, Li, Xueliang, Zhang, Tao, Deng, Jianping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10133545/
https://www.ncbi.nlm.nih.gov/pubmed/37122297
http://dx.doi.org/10.3389/fneur.2023.1133091
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author Lu, Dan
Li, Yuqian
Yang, Zijian
Zhao, Zhenwei
Fang, Wei
Chen, Lei
Ma, Tao
Wang, Naibing
Li, Xueliang
Zhang, Tao
Deng, Jianping
author_facet Lu, Dan
Li, Yuqian
Yang, Zijian
Zhao, Zhenwei
Fang, Wei
Chen, Lei
Ma, Tao
Wang, Naibing
Li, Xueliang
Zhang, Tao
Deng, Jianping
author_sort Lu, Dan
collection PubMed
description OBJECTIVE: The typical pressure cooker technique (PCT) and several modifications with similar mechanisms have been introduced to enhance the embolization of brain arteriovenous malformations (bAVMs). This study aimed to assess the effectiveness of transarterial embolization of bAVMs with the PCT. METHOD: From January 2019 to December 2021, 125 consecutive patients with bAVM managed by transarterial embolization in the prospective database on cerebral vascular diseases of a single center were retrospectively reviewed. Patient data and lesion characteristics were collected. According to the treatment strategy, the patients were assigned to the PCT group (46 patients) and conventional embolization technique (CET) group (79 patients). RESULTS: Baseline patient features were comparable between the two groups. After the first procedure, complete obliteration immediately was observed in 61 and 42% of patients in the PCT and CET groups, respectively. The rate was markedly elevated in the PCT group (p = 0.04). In subgroup analysis, the rate of immediate complete obliteration was starkly increased in PCT group patients with Spetzler-Martin grade I/II bAVM (86 and 53% in the PCT and CET groups, respectively; p = 0.0036). The overall complication rates were similar in the two groups (13 and 10% in the PCT and CET groups, respectively; p = 0.77). In multivariable analysis, nidus size >3 cm (OR = 8.826, 95% CI: 1.250–62.312; p = 0.03) and deep location (OR = 8.576, 95% CI: 1.480–49.690; p = 0.02) were significant factors affecting complete obliteration in the PCT group. CONCLUSION: The PCT may yield a higher rate of immediate complete obliteration with transarterial embolization of bAVMs, without increasing the rate of procedure-related complications.
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spelling pubmed-101335452023-04-28 Application of the pressure cooker technique for transarterial embolization of brain arteriovenous malformations: Factors affecting obliteration and outcomes Lu, Dan Li, Yuqian Yang, Zijian Zhao, Zhenwei Fang, Wei Chen, Lei Ma, Tao Wang, Naibing Li, Xueliang Zhang, Tao Deng, Jianping Front Neurol Neurology OBJECTIVE: The typical pressure cooker technique (PCT) and several modifications with similar mechanisms have been introduced to enhance the embolization of brain arteriovenous malformations (bAVMs). This study aimed to assess the effectiveness of transarterial embolization of bAVMs with the PCT. METHOD: From January 2019 to December 2021, 125 consecutive patients with bAVM managed by transarterial embolization in the prospective database on cerebral vascular diseases of a single center were retrospectively reviewed. Patient data and lesion characteristics were collected. According to the treatment strategy, the patients were assigned to the PCT group (46 patients) and conventional embolization technique (CET) group (79 patients). RESULTS: Baseline patient features were comparable between the two groups. After the first procedure, complete obliteration immediately was observed in 61 and 42% of patients in the PCT and CET groups, respectively. The rate was markedly elevated in the PCT group (p = 0.04). In subgroup analysis, the rate of immediate complete obliteration was starkly increased in PCT group patients with Spetzler-Martin grade I/II bAVM (86 and 53% in the PCT and CET groups, respectively; p = 0.0036). The overall complication rates were similar in the two groups (13 and 10% in the PCT and CET groups, respectively; p = 0.77). In multivariable analysis, nidus size >3 cm (OR = 8.826, 95% CI: 1.250–62.312; p = 0.03) and deep location (OR = 8.576, 95% CI: 1.480–49.690; p = 0.02) were significant factors affecting complete obliteration in the PCT group. CONCLUSION: The PCT may yield a higher rate of immediate complete obliteration with transarterial embolization of bAVMs, without increasing the rate of procedure-related complications. Frontiers Media S.A. 2023-04-13 /pmc/articles/PMC10133545/ /pubmed/37122297 http://dx.doi.org/10.3389/fneur.2023.1133091 Text en Copyright © 2023 Lu, Li, Yang, Zhao, Fang, Chen, Ma, Wang, Li, Zhang and Deng. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Lu, Dan
Li, Yuqian
Yang, Zijian
Zhao, Zhenwei
Fang, Wei
Chen, Lei
Ma, Tao
Wang, Naibing
Li, Xueliang
Zhang, Tao
Deng, Jianping
Application of the pressure cooker technique for transarterial embolization of brain arteriovenous malformations: Factors affecting obliteration and outcomes
title Application of the pressure cooker technique for transarterial embolization of brain arteriovenous malformations: Factors affecting obliteration and outcomes
title_full Application of the pressure cooker technique for transarterial embolization of brain arteriovenous malformations: Factors affecting obliteration and outcomes
title_fullStr Application of the pressure cooker technique for transarterial embolization of brain arteriovenous malformations: Factors affecting obliteration and outcomes
title_full_unstemmed Application of the pressure cooker technique for transarterial embolization of brain arteriovenous malformations: Factors affecting obliteration and outcomes
title_short Application of the pressure cooker technique for transarterial embolization of brain arteriovenous malformations: Factors affecting obliteration and outcomes
title_sort application of the pressure cooker technique for transarterial embolization of brain arteriovenous malformations: factors affecting obliteration and outcomes
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10133545/
https://www.ncbi.nlm.nih.gov/pubmed/37122297
http://dx.doi.org/10.3389/fneur.2023.1133091
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