Embolic Agents and Microcatheters for Endovascular Treatment of Cerebral Arteriovenous Malformations.

Autor: Triano MJ; Department of Neurosurgery, Georgetown University School of Medicine, Washington, DC, USA., Lara-Reyna J; Department of Neurosurgery, Mount Sinai Health System, New York, New York, USA., Schupper AJ; Department of Neurosurgery, Mount Sinai Health System, New York, New York, USA., Yaeger KA; Department of Neurosurgery, Mount Sinai Health System, New York, New York, USA. Electronic address: kurt.yaeger@mountsinai.org.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2020 Sep; Vol. 141, pp. 383-388. Date of Electronic Publication: 2020 Jun 24.
DOI: 10.1016/j.wneu.2020.06.118
Abstrakt: Endovascular embolization of cerebral arteriovenous malformations (AVMs) originally entailed delivery of N-butyl cyanoacrylate glue to the nidus via a flow-directed microcatheter. Within the past decade, several new liquid embolic agents and novel microcatheter technologies have become available that have improved the ease of use and efficacy of endovascular therapies for AVMs. Nonadhesive copolymers, such as Onyx and Precipitating Hydrophobic Injectable Liquid, have largely replaced N-butyl cyanoacrylate given a lower risk of catheter entrapment. The emergence of balloon microcatheters has allowed for improved protection of the normal cerebral vasculature and has improved the penetration of liquid embolics into large AVMs, ultimately reducing procedure times and radiation exposure. Finally, several detachable tip microcatheters have been developed to facilitate removal of the catheter from hardened liquid embolic cast, preventing the morbidity associated with distal catheter entrapment. This article reviews the embolic agents and microcatheters currently available for the treatment of cerebral AVMs in the United States as well as the data demonstrating the safety and efficacy of these devices.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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