Dissertation > Medicine, health > Neurology and psychiatry > Neurology > Cerebrovascular disease > Cerebral vascular malformations

Endovascular Treatment of Cerebral Aneurysms and Arteriovenous Malformations with Non-adhesive Liquid Embolic Material

Author HeHongWei
Tutor PangZuo;WuZhongXue
School Shandong University
Course Surgery
Keywords Cerebral aneurysm Cerebral arteriovenous malformation Endovascular treatment Cellulose acetate polymer (CAP) Onyx (ethylene-vinyl alcohol copolymer EVOH + DMSO + tantalum)
CLC R743.4
Type PhD thesis
Year 2006
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Cerebral aneurysm and arteriovenous malformation are frequent disease of cerebral vessels. Because of leading to cerebral hemorrhage and endangering the life of patients, they must be diagnosed and treated earlier. The endovascular treatment is an important therapeutic tool of cerebral aneurysm and arteriovenous malformation, and its efficacy largely depends on the embolic material employed. Nowdays, the platinum microcoil is the most commonly used embolic material for the treatment of cerebral aneurysm, especially the small aneurysm. In remodeling technique, the microcoils can be used to embolize the large or wide-neck aneurysms well, but not to enough closing, and part of aneurysm is remained or aneuryam occurred recanalization. If the embolic material for aneurysm is used the liquid material in the remodeling, the above-mentioned defects will be avoided. There is a lot of embolic material for the cerebral arteriovenous malformation (AVM), such as microcoils, solid beads, silks, but the liquid material is the most common embolic material for AVMs. Now cyanoacrylate glue, such as NBCA, is used to embolized the small AVMs because of their adhesiveness. But the large AVMs is mainly embolized by non-adhesive liquid material.Because the major disadvantage of adhesive liquid material is the risk of adhering the microcatheter to the target vessel wall, their use requires abundant experiences in choosing their concentration, the time and rate of injection. The exploitation of non-adhesive liquid material becomes a common topic of world scholars. They are the series of polymers, insoluble in water, but soluble in organic solvents such as DMSO (Dimethyl Sulfoxide) or ethanol. These polymer/organic solvent mixtures, once contacted with aqueous solutions, solidify quickly while the solvent diffuse to the water, without adhesiveness. DMSO has the angiotoxicity, so its use requires strict handling in volume and rate of injection.CAP (cellulose acetate polymer) and Onyx (ethylene-vinyl alcohol copolymer,

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