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Registration Number

0221U101992, 0118U000005 , R & D reports

Title

To study clinical features and to develop tactics of endovascular treatment of patients with arterovenous malformations combined with aneurysms of cerebral vessels

Head

Scheglov Dmitry V., Доктор медичних наук

Registration Date

27-01-2021

Organization

State Institution “Research and Practical Center for Endovascular Neuroradiology of National Academy of Medical Sciences of Ukraine”

Description

130 patients with arteriovenous malformations (AVM) and cerebral vascular aneurysms (CVA) were examined and treated. The features of clinical manifestations in the association of AVM and CVA depending on angioarchitectonics and anatomical-hemodynamic ratio were determined. The hemodynamically - dependent aneurysms in the AVM are a factor of possible re-hemorrhage in the acute period of the disease. The relationship between the localization of the aneurysm in the structure of the AVM and the clinical manifestation of the disease was proved. A new, X-ray classification of aneurysms in the structure of the AVM, which has no analogues, has been developed. There are 4 types of aneurysms in the structure of cerebral AVM: I - arterial-paranidal aneurysms (PA); II - intranidal aneurysms; III - venous-paranidal aneurysms; IV - multiple aneurysms. The criteria for distribution between different types were considered to be the predominant angiographic phase of aneurysm contrast in the structure of the AVM and its localization: in the arteries, directly in the nodus of the malformation and in the veins, respectively. Analysis of hemorrhagic manifestations of aneurysms in the structure of the AVM indicates the highest risk of hemorrhage in arterial - paranidal aneurysms of type I and the absolute risk of multiple PA - type IV. Correlation analysis showed that the frequency of hemorrhages in patients with PA decreases as the associated aneurysms deepen into the structure of the malformation. The introduction of a new classification makes it possible to conduct a qualitative diagnosis and assessment of this double disease of the vessels of the brain, to predict the relative risks of hemorrhage. Differentiated indications for the use of different types of endovascular operations in the combination of AVM and CVA, depending on the classification type, aimed at timely primary and secondary prevention of hemorrhagic complications and identified the most effective treatments.  

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Bortnik Igor M
Vival Mikola B
Sviriduk Oleg E.
Selvanyuk Ludmila S
Sidorenko Olena F
Хлопенова В.П.
Chebanyuk Svitlana V