{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T02:49:44Z","timestamp":1792896584824,"version":"4.5.0"},"reference-count":50,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1992,4]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 Embolization with polyvinyl alcohol (PVA) is an accepted method of rendering complex arteriovenous malformations (AVM's) more amenable to surgery, but its effects on human vascular tissues have not been adequately documented. The authors reviewed the histopathology of 66 intracranial AVM's resected 1 to 76 days after embolization with PVA. The mean age of the patients was 36 years, and their AVM's were located in the cerebral hemispheres (92%), the cerebellum (6%), or the corpus callosum (2%). In 79% of cases, at least one vessel contained PVA particles; in most cases, the vessel was filled with sharp, angular PVA particles in a serpiginous pattern. Polyvinyl alcohol particles indented the endothelium in 69% of cases but were rarely found subendothelially. Clotted blood and fibroblasts were present among the particles, and abundant intraluminal mononuclear and polymorphonuclear inflammatory cells were found in all vessels containing PVA particles. Foreign-body giant cells appeared 2 to 14 days after embolization in the majority of cases. Patchy mural angionecrosis and necrotizing vasculitis were found in 39% of the cases. Recanalized lumina were seen in 18% of PVA-embolized vessels. Foreign materials resembling cotton fibers and other particulate substances, which were probably contaminants of the contrast solution or the embolic material, were found in 65% of the cases. These findings suggest a specific chain of events in the interaction between PVA and vessel wall components and may explain some important sequelae of embolization therapy.<\/jats:p>","DOI":"10.3171\/jns.1992.76.4.0607","type":"journal-article","created":{"date-parts":[[2009,5,26]],"date-time":"2009-05-26T20:58:41Z","timestamp":1243371521000},"page":"607-614","source":"Crossref","is-referenced-by-count":84,"title":["Histopathological follow-up study of 66 cerebral arteriovenous malformations after therapeutic embolization with polyvinyl alcohol"],"prefix":"10.3171","volume":"76","author":[{"given":"Isabelle M.","family":"Germano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard L.","family":"Davis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles B.","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant B.","family":"Hieshima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Surgery","first-page":"727","article-title":"Ivalon baffle for posterior leaflet replacement in the treatment of mitral valve insufficiency: a follow-up study.","volume":"63","author":"Barnard","year":"1968"},{"key":"b2","series-title":"AJNR","first-page":"579","article-title":"Preoperative embolization of arteriovenous malformations with polylene threads: techniques with wing microcatheter and pathologic results.","volume":"10","author":"Benati","year":"1989"},{"key":"b3","series-title":"AJNR","first-page":"261","article-title":"Microembolization techniques of vascular occlusion: radiologic, pathologic, and clinical correlation.","volume":"2","author":"Berenstein","year":"1981"},{"key":"b4","series-title":"Acta Radiol (Diagn)","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1177\/028418517501600607","article-title":"Glass fragments and other particles contaminating contrast media.","volume":"16","author":"Brekkan","year":"1975"},{"key":"b5","series-title":"AJNR","first-page":"777","article-title":"N-Butyl 2-cyanoacrylate-substitute for iBCA in interventional neuroradiology: histopathologic and polymerization time studies.","volume":"10","author":"Brothers","year":"1989"},{"key":"b6","series-title":"J Pathol","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1002\/path.1711050408","article-title":"Macrophages and multinucleate giant cells in nitrosoquinoline-induced granulomata in rats: an autoradiographic study.","volume":"105","author":"Carter","year":"1971"},{"key":"b7","series-title":"AJR","doi-asserted-by":"publisher","first-page":"627","DOI":"10.2214\/ajr.136.3.627","article-title":"\u201cSpideron:\u201d new device for simple, fast arterial and venous occlusion.","volume":"136","author":"Castaneda-Zuniga","year":"1981"},{"key":"b8","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1148\/132.3.599","article-title":"Therapeutic embolization of facial arteriovenous fitstulae.","volume":"132","author":"Casta\u00f1eda-Zu\u00f1iga","year":"1979"},{"key":"b9","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1148\/126.3.783","article-title":"Experimental observations on short- and long-term effects of arterial occlusion with Ivalon.","volume":"126","author":"Castaneda-Zuniga","year":"1978"},{"key":"b10","series-title":"AJR","doi-asserted-by":"publisher","first-page":"729","DOI":"10.2214\/ajr.136.4.729","article-title":"Ivalon embolization in abdominal neoplasms.","volume":"136","author":"Chuang","year":"1981"},{"key":"b11","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"705","DOI":"10.3171\/jns.1980.52.5.0705","article-title":"Treatment of cerebral arteriovenous malformations. A combined neurosurgical and neuroradiological approach.","volume":"52","author":"Cromwell","year":"1980"},{"key":"b12","series-title":"AJNR","first-page":"366","article-title":"Treatment of cerebral arteriovenous malformations: combined neurosurgical and neuroradiological approach.","volume":"4","author":"Cromwell","year":"1983"},{"key":"b13","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1056\/NEJM197503272921308","article-title":"Fiber embolization \u2014 a hazard of cardiac surgery and catheterization.","volume":"292","author":"Dimmick","year":"1975"},{"key":"b14","series-title":"Neuroradiology","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1007\/BF00338854","article-title":"Embolization by superselective arteriography from the femoral route in neuroradiology. Review of 60 cases. 1. Technique, indications, complications.","volume":"6","author":"Djindjian","year":"1973"},{"key":"b15","series-title":"Clin Neurosurg","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1093\/neurosurgery\/26.CN_suppl_1.145","article-title":"Cerebral arteriovenous malformations: considerations for and experience with surgical treatment in 166 cases.","volume":"26","author":"Drake","year":"1979"},{"key":"b16","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1148\/132.1.51","article-title":"Long-term radiographic-pathologic follow-up of patients treated with visceral transcatheter occlusion using isobutyl 2-cyano-acrylate (bucrylate).","volume":"132","author":"Freeny","year":"1979"},{"key":"b17","series-title":"J Thorac Surg","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1016\/S0096-5588(20)31049-7","article-title":"Plastic sponge prosthesis following resection in pulmonary tuberculosis.","volume":"24","author":"Gale","year":"1952"},{"key":"b18","series-title":"Arch Pathol","first-page":"171","article-title":"Intravenous injection of talc in a narcotics addict.","volume":"94","author":"Groth","year":"1972"},{"key":"b19","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1227\/00006123-198802000-00004","article-title":"Preoperative balloon occlusion of arteriovenous malformations.","volume":"22","author":"Halbach","year":"1988"},{"key":"b20","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1148\/radiology.144.3.7100485","article-title":"Ivalon shavings: technical considerations of a new embolic agent.","volume":"144","author":"Herrara","year":"1982"},{"key":"b21","series-title":"AJNR","first-page":"595","article-title":"Polyvinyl alcohol sponge for embolotherapy: particle size and morphology.","volume":"6","author":"Jack","year":"1985"},{"key":"b22","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1148\/radiology.137.1.7422847","article-title":"Transcatheter embolization in the management of congenital arteriovenous malformations.","volume":"137","author":"Kaufman","year":"1980"},{"key":"b23","series-title":"Invest Radiol","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1097\/00004424-198705000-00006","article-title":"Low-dose particulate polyvinylalcohol embolization in massive small artery intestinal hemorrhage. Experimental and clinical results.","volume":"22","author":"Kusano","year":"1987"},{"key":"b24","series-title":"Neuroradiology","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/BF00341935","article-title":"The pathology of encephalic arteriovenous malformations treated by prior embolotherapy.","volume":"30","author":"Lanman","year":"1988"},{"key":"b25","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1148\/131.3.669","article-title":"Polyvinyl foam embolization of vascular and neoplastic lesions of the head, neck, and spine.","volume":"131","author":"Latchaw","year":"1979"},{"key":"b26","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"14","DOI":"10.3171\/jns.1984.60.1.0014","article-title":"Cerebral arteriovenous malformations. Indications for and results of surgery, and the role of intravascular techniques.","volume":"60","author":"Luessenhop","year":"1984"},{"key":"b27","series-title":"J Pathol","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1002\/path.1711200304","article-title":"Immunological and non-immunological phagocytosis by inflammatory macrophages, epithelioid cells and macrophage polykaryons from foreign body granulomata.","volume":"120","author":"Mariano","year":"1976"},{"key":"b28","series-title":"J Cell Biol","doi-asserted-by":"publisher","first-page":"1648","DOI":"10.1083\/jcb.97.5.1648","article-title":"In vitro rapid organization of endothelial cells into capillary-like networks is promoted by collagen matrices.","volume":"97","author":"Montesano","year":"1983"},{"key":"b29","series-title":"J Pathol","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1002\/path.1711200402","article-title":"Selective release of lysosomal enzymes from cell populations containing multinucleate giant cells.","volume":"120","author":"Papadimitriou","year":"1976"},{"key":"b30","series-title":"Nature","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1038\/269804a0","article-title":"Activated macrophages induce vascular proliferation.","volume":"269","author":"Polverini","year":"1977"},{"key":"b31","series-title":"Radiol Clin North Am","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/S0033-8389(22)01768-7","article-title":"Catheter closure of patient ductus arteriosus: 62 cases treated without thoracotomy.","volume":"9","author":"Porstmann","year":"1971"},{"key":"b32","series-title":"AJNR","first-page":"101","article-title":"Histopathologic analysis of intraarterial polyvinyl alcohol microemboli in rat cerebral cortex.","volume":"5","author":"Quisling","year":"1984"},{"key":"b33","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1148\/radiology.170.2.2911663","article-title":"Mortalities associated with use of a commercial suspension of polyvinyl alcohol.","volume":"170","author":"Repa","year":"1989"},{"key":"b34","series-title":"Pathology of Tumours of the Nervous System","first-page":"136","author":"Russell","year":"1977"},{"key":"b35","series-title":"AJNR","first-page":"957","article-title":"Superselective injection of polyvinyl alcohol microemboli for the treatment of cerebral arteriovenous malformations.","volume":"6","author":"Scialfa","year":"1985"},{"key":"b36","series-title":"Arch Neurol","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1001\/archneur.1960.00450060099011","article-title":"Foreign body emboli following cerebral angiography.","volume":"3","author":"Silberman","year":"1960"},{"key":"b37","series-title":"Exp Mol Pathol","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1016\/0014-4800(87)90048-7","article-title":"Multinucleate foreign-body giant cell formation.","volume":"46","author":"Smetana","year":"1987"},{"key":"b38","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"17","DOI":"10.3171\/jns.1987.67.1.0017","article-title":"Surgical management of large AVM's by staged embolization and operative excision.","volume":"67","author":"Spetzler","year":"1987"},{"key":"b39","series-title":"AJR","doi-asserted-by":"publisher","first-page":"609","DOI":"10.2214\/ajr.125.3.609","article-title":"Polyvinyl alcohol (Ivalon) \u2014 a new embolic material.","volume":"125","author":"Tadavarthy","year":"1975"},{"key":"b40","series-title":"Hum Pathol","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1016\/S0046-8177(88)80204-1","article-title":"Longterm histopathologic follow-up of bronchial arteries after therapeutic embolization with polyvinyl alcohol (Ivalon) in patients with cystic fibrosis.","volume":"19","author":"Tomashefski","year":"1988"},{"key":"b41","series-title":"Arch Neurol","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1001\/archneur.1983.04050040051008","article-title":"\u201cForeign\u201d particles in encephalic vascular malformations.","volume":"40","author":"Vinters","year":"1983"},{"key":"b42","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1056\/NEJM198602203140804","article-title":"Long-term pathological follow-up of cerebral arteriovenous malformations treated by embolization with bucrylate.","volume":"314","author":"Vinters","year":"1986"},{"key":"b43","series-title":"AJNR","first-page":"919","article-title":"Angiographic follow-up of large cerebral AVM's incompletely embolized with isobutyl-2-cyanoacrylate.","volume":"7","author":"Vi\u00f1uela","year":"1986"},{"key":"b44","series-title":"Br J Radiol","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1259\/0007-1285-53-628-289","article-title":"Percutaneous arterial embolization in the kidneys of dogs: a comparative study of eight different materials.","volume":"53","author":"Vlahos","year":"1980"},{"key":"b45","series-title":"AJR","doi-asserted-by":"publisher","first-page":"381","DOI":"10.2214\/ajr.127.3.381","article-title":"Therapeutic vascular occlusion utilizing steel coil technique: clinical applications.","volume":"127","author":"Wallace","year":"1976"},{"key":"b46","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1148\/125.3.677","article-title":"Therapeutic embolization with long-term occluding agents and their effects on embolized tissues.","volume":"125","author":"White","year":"1977"},{"key":"b47","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"446","DOI":"10.3171\/jns.1979.51.4.0446","article-title":"Microsurgical treatment of intracranial vascular malformations.","volume":"51","author":"Wilson","year":"1979"},{"key":"b48","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1148\/radiology.134.2.7352208","article-title":"Intrinsic particles in angiographic contrast media.","volume":"134","author":"Winding","year":"1980"},{"key":"b49","series-title":"Neuroradiology","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1007\/BF00338550","article-title":"Catheter embolization of intracranial arteriovenous malformations as an aid to surgical excision.","volume":"10","author":"Wolpert","year":"1975"},{"key":"b50","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1148\/radiology.136.3.7403540","article-title":"Therapeutic blockade of arteries using compressed Ivalon.","volume":"136","author":"Zollikofer","year":"1980"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/76\/4\/article-p607.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/76\/4\/article-p607.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/76\/4\/article-p607.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T00:32:23Z","timestamp":1679272343000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/76\/4\/article-p607.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1992,4]]},"references-count":50,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/jns.1992.76.4.0607","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1992,4]]}}}