Lytvak S. Surgical treatment of arteriovenous malformations of vertebrobasilar system

The results of complex clinical and instrumental investigation of 136 patients with arteriovenous malformations (AVM) of vertebrobasilar system (VBS) were analyzed. Typical AVM clinical sing is stroke with hemorrhage component - in 114 (83.82%) patients, malformation rapture repeated in 41 (30.15%) cases. In 38 (33.33%) patients neurological disorders at hospitalization was estimated according NIHSS as moderate - in 38 (33.33%) cases, as heavy - in 32 (28.07%).Operations were performed using new conception, worked out on basis of complex analysis of structural, hemodynamic and neurological parameters of AVM VBS surgical treatment. Microsurgical removing of AVM was performed in 38 (27.94%) cases, endovascular embolization of AVM kernel and afferents - in 67 (49.27%), radiosurgery was used in 6 (4.41%) patients, combined treatment - in 25 (18.38%).In result of surgical treatment improvement was achieved in 108 (79.41%) cases, without dynamics - in 17 (12.5%), worsening - in 5 (3.68%). Complications were marked in 14 (10.29%) cases. 6 (4.41) patients died. In result of surgical treatment the degree of AVM VBS devascularisation was achieved: total - in 94 (62.12%) observations, subtotal - in 30 (22.06%), partial - in 12 (8.82%).