術前塞栓術を併用したAVM手術(<特集>AVMの手術)  [in Japanese] AVM Operation with Preoperative Embolization(<Topic>Operation for Cerebral AVMs)  [in Japanese]

Multimodal treatment for AVM has been established, improving the outcome of patients with AVM. Preoperative embolization with microsurgical resection was an important multimodal management approach. In this paper, we retrospectively analyzed the outcome and benefit of this treatment. In 20 of 97 patients with microsurgical resection of AVM, perioperative embolization was performed between 1974 and 2005 in our department. There were no complications of perioperative embolization. Surgery was performed 1 to 3 days after perioperative embolization. In these patients, feeders that had been embolized were often easier to be coagulated. In addition, intraluminal embolic agents can help the operator identify feeders that require occlusion, as distinguished from normal arteries en passage that require be preservation. Moreover, reduction of blood loss and operation time was another merit. Perioperative embolization is beneficial especially for patients with Spetzler & Martin Grade II and III.