{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:51:40Z","timestamp":1790617900936,"version":"4.1.0"},"reference-count":27,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1993,1]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 Endovascular therapy of cerebral arteriovenous malformations (AVM's) is an accepted adjunct to surgical therapy. However, the literature has not characterized the benefits or the liabilities of preoperative embolization. This series compares two groups of patients who underwent surgical resection of a cerebral AVM; one group (20 patients) received preoperative transfemoral selective embolization with N-butyl cyanoacrylate (NBCA) and the other group (13 patients) did not. In the group with preoperative embolization, the AVM's were larger (3.9 vs. 2.3 cm) and of a higher Spetzler-Martin grade (3.2 vs. 2.5) as compared to the nonembolized group. The NBCA embolization facilitated surgical resection. Arteries supplying the vascular malformation were readily distinguished from those supplying the normal brain parenchyma. Embolized vessels were compressible and easily cut with microscissors. No bleeding occurred from transected vessels. Operative time and intraoperative blood loss for the two groups were not statistically different, despite the significant differences in lesion size and grade. Endovascular complications included immediate and delayed hemorrhage (15%) and transient ischemia (5%); there were no embolization-related deaths. Postoperative complications for both groups included hemorrhage (15%), residual AVM (6%), and cerebrospinal fluid leak (3%); the mortality rate was 3%. There was no statistically significant difference in surgical complications between the embolized and nonembolized groups. Most patients (91%) in both groups had an excellent or good late neurological outcome, with no significant difference between the groups. This study concludes that preoperative NBCA embolization of AVM's makes lesions of larger size and higher grade the surgical equivalent of lesions of smaller size and lower grade by reducing operative time and intraoperative blood loss, with no statistically significant difference in surgical complications or long-term neurological outcome.<\/jats:p>","DOI":"10.3171\/jns.1993.78.1.0060","type":"journal-article","created":{"date-parts":[[2009,5,27]],"date-time":"2009-05-27T15:36:25Z","timestamp":1243438585000},"page":"60-69","source":"Crossref","is-referenced-by-count":243,"title":["The effect of embolization with N-butyl cyanoacrylate prior to surgical resection of cerebral arteriovenous malformations"],"prefix":"10.3171","volume":"78","author":[{"given":"Jafar J.","family":"Jafar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J.","family":"Davis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Berenstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In Sup","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Kupersmith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Radiology","first-page":"609","article-title":"Treatment of intracerebral arteriovenous malformations with isobutyl 2-cyanoacrylate: initial clinical experience.","volume":"139","author":"Bank","year":"1981"},{"key":"b2","series-title":"AJNR","first-page":"128","article-title":"Complications of therapeutic transarterial embolization cooperative study.","volume":"1","author":"Berenstein","year":"1980"},{"key":"b3","series-title":"Surgical Neuroangiography. Vol 4: Endovascular Neurosurgery of Brain Vascular Lesions.","first-page":"189","author":"Berenstein","year":"1991"},{"key":"b4","series-title":"AJNR","first-page":"883","article-title":"Embolization with N-butyl-cyanoacrylate in the management of CNS lesions.","volume":"10","author":"Berenstein","year":"1989"},{"key":"b5","series-title":"J Neurosurg","first-page":"705","article-title":"Treatment of cerebral arteriovenous malformations. A combined neurosurgical and neuroradiological approach.","volume":"52","author":"Cromwell","year":"1980"},{"key":"b6","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":"b7","series-title":"J Neurosurg","first-page":"615","article-title":"Embolization of cerebral arteriovenous malformations with bucrylate. Experience in 46 cases.","volume":"56","author":"Debrun","year":"1982"},{"key":"b8","series-title":"Clin Neurosurg","first-page":"145","article-title":"Cerebral arteriovenous malformations: considerations for and experience with surgical treatment in 166 cases.","volume":"26","author":"Drake","year":"1979"},{"key":"b9","series-title":"J Neurosurg","first-page":"228","article-title":"Endovascular treatment of intracerebral arteriovenous malformations: experience in 49 cases.","volume":"75","author":"Fournier","year":"1991"},{"key":"b10","series-title":"Neurosurgery","first-page":"570","article-title":"Surgical excision of cerebral arteriovenous malformations: late results.","volume":"26","author":"Heros","year":"1990"},{"key":"b11","series-title":"Postoperative Complications of Intracranial Neurological Surgery.","first-page":"182","year":"1982"},{"key":"b12","series-title":"Intracranial Vascular Malformations.","first-page":"157","article-title":"Complications of complete surgical resection of AVM's of the brain","author":"Korosue","year":"1990"},{"key":"b13","series-title":"Neurosurg Rev","first-page":"265","article-title":"Endovascular treatment of cerebral arteriovenous malformations.","volume":"9","author":"Lasjaunias","year":"1986"},{"key":"b14","series-title":"J Neurosurg","first-page":"14","article-title":"Cerebral arteriovenous malformations. Indications for and results of surgery, and the role of intravascular techniques.","volume":"60","author":"Luessenhop","year":"1984"},{"key":"b15","series-title":"Surgical Management of Cerebrovascular Disease","first-page":"347","author":"Ojemann","year":"1988"},{"key":"b16","series-title":"Neurosurgery","first-page":"358","article-title":"Treatment of cerebral arteriovenous malformations with a combination of preoperative embolization and surgery.","volume":"29","author":"Pasqualin","year":"1991"},{"key":"b17","series-title":"Neurosurgery","first-page":"625","article-title":"Commentary on Day AL, Friedman WA, Sypert GW, et al: Successful treatment of the normal perfusion pressure breakthrough syndrome.","volume":"11","author":"Peerless","year":"1982"},{"key":"b18","series-title":"Acta Neurochir Suppl","first-page":"55","article-title":"Surgical versus conservative treatment of intracranial arteriovenous malformations \u2014 V. Surgical treatment.","volume":"29","author":"Pellettieri","year":"1980"},{"key":"b19","series-title":"AJNR","first-page":"757","article-title":"Preoperative embolization of brain AVM's with isobutyl 2-cyanoacrylate.","volume":"9","author":"Pelz","year":"1988"},{"key":"b20","series-title":"J Neurosurg","first-page":"205","article-title":"Management of hemorrhagic complications from preoperative embolization of arteriovenous malformations.","volume":"74","author":"Purdy","year":"1991"},{"key":"b21","series-title":"Neurosurgery","first-page":"43","article-title":"Intravascular use of isobutyl 2-cyanoacrylate: Part 1. Treatment of intracranial arteriovenous malformations.","volume":"8","author":"Samson","year":"1981"},{"key":"b22","series-title":"J Neurosurg","first-page":"476","article-title":"A proposed grading system for arteriovenous malformations.","volume":"65","author":"Spetzler","year":"1986"},{"key":"b23","series-title":"J Neurosurg","first-page":"17","article-title":"Surgical management of large AVM's by staged embolization and operative excision.","volume":"67","author":"Spetzler","year":"1987"},{"key":"b24","series-title":"AJNR","first-page":"959","article-title":"Dominant-hemisphere arteriovenous malformations: therapeutic embolization with isobutyl-2-cyanoacrylate.","volume":"4","author":"Vi\u00f1uela","year":"1983"},{"key":"b25","series-title":"Intracranial Vascular Malformations.","first-page":"169","article-title":"Interventional neuroradiology for intracranial arteriovenous malformations","author":"Vi\u00f1uela","year":"1990"},{"key":"b26","series-title":"AJNR","first-page":"1233","article-title":"Progressive thrombosis of brain arteriovenous malformations after embolization with isobutyl 2-cyanoacrylate.","volume":"4","author":"Vi\u00f1uela","year":"1983"},{"key":"b27","series-title":"J Neurosurg","first-page":"446","article-title":"Microsurgical treatment of intracranial vascular malformations.","volume":"51","author":"Wilson","year":"1979"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/78\/1\/article-p60.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/78\/1\/article-p60.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/78\/1\/article-p60.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,19]],"date-time":"2023-03-19T21:29:42Z","timestamp":1679261382000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/78\/1\/article-p60.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1993,1]]},"references-count":27,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/jns.1993.78.1.0060","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1993,1]]}}}