Abstract：
To evaluate whether intraoperative neuromonitoring (IONM), including pre-embolization lidocaine injection challenge (\"provocative testing\") is associated with reduced risk of irreversible nerve injury during embolization of peripheral arteriovenous malformations (AVMs).
Medical records of patients with peripheral AVMs who underwent embolotherapy with IONM with provocative testing between 2012 and 2021 were reviewed retrospectively. Data collected included patient demographic characteristics, AVM location and size, embolic agent used, IONM signal changes after lidocaine and embolic agent injections, postprocedural adverse events, and clinical outcomes. Decisions regarding whether embolization would proceed at specific locations were based on IONM findings after the lidocaine challenge and as embolization proceeded.
A cohort of 17 patients (mean age, 27 years ± 19; 5 women) who underwent 59 image-guided embolization procedures with adequate IONM data was identified. No permanent neurologic deficits occurred. Transient neurologic deficits were observed in 3 patients (4 sessions), comprising skin numbness (2 patients), extremity weakness (1 patient), and extremity weakness and numbness (1 patient). All neurologic deficits resolved by postoperative day 4 without additional treatment.
IONM, including provocative testing, during AVM embolization may minimize potential nerve injury.
Medical records of patients with peripheral AVMs who underwent embolotherapy with IONM with provocative testing between 2012 and 2021 were reviewed retrospectively. Data collected included patient demographic characteristics, AVM location and size, embolic agent used, IONM signal changes after lidocaine and embolic agent injections, postprocedural adverse events, and clinical outcomes. Decisions regarding whether embolization would proceed at specific locations were based on IONM findings after the lidocaine challenge and as embolization proceeded.
A cohort of 17 patients (mean age, 27 years ± 19; 5 women) who underwent 59 image-guided embolization procedures with adequate IONM data was identified. No permanent neurologic deficits occurred. Transient neurologic deficits were observed in 3 patients (4 sessions), comprising skin numbness (2 patients), extremity weakness (1 patient), and extremity weakness and numbness (1 patient). All neurologic deficits resolved by postoperative day 4 without additional treatment.
IONM, including provocative testing, during AVM embolization may minimize potential nerve injury.
摘要：
目的：本研究评估术中神经监测（IONM）包括栓塞前利多卡因注射激发(“激发试验”)与外周动静脉畸形(AVM)栓塞期间不可逆神经损伤风险降低相关。
方法：回顾性分析了2012-2021年间接受IONM栓塞治疗的外周AVM患者的病历。收集的数据包括患者人口统计学特征，AVM位置和大小，使用栓塞剂，注射利多卡因和栓塞剂后IONM信号变化，术后不良事件,和临床结果。关于栓塞是否会在特定位置进行的决定是基于利多卡因攻击后IONM的发现。随着栓塞的进行。
结果：一组17例患者（平均年龄27±19岁；5例女性）接受了59例图像引导栓塞手术，并有足够的IONM数据。没有发生永久性神经缺陷。在3例患者（4个疗程）中观察到短暂性神经功能缺损，包括皮肤麻木（2名患者），四肢无力（1名患者），四肢无力和麻木（1名患者）。所有神经功能缺损在术后第4天解决，无需额外治疗。
结论：IONM，包括挑衅性的测试，在AVM栓塞期间可能会减少潜在的神经损伤。
方法：回顾性分析了2012-2021年间接受IONM栓塞治疗的外周AVM患者的病历。收集的数据包括患者人口统计学特征，AVM位置和大小，使用栓塞剂，注射利多卡因和栓塞剂后IONM信号变化，术后不良事件,和临床结果。关于栓塞是否会在特定位置进行的决定是基于利多卡因攻击后IONM的发现。随着栓塞的进行。
结果：一组17例患者（平均年龄27±19岁；5例女性）接受了59例图像引导栓塞手术，并有足够的IONM数据。没有发生永久性神经缺陷。在3例患者（4个疗程）中观察到短暂性神经功能缺损，包括皮肤麻木（2名患者），四肢无力（1名患者），四肢无力和麻木（1名患者）。所有神经功能缺损在术后第4天解决，无需额外治疗。
结论：IONM，包括挑衅性的测试，在AVM栓塞期间可能会减少潜在的神经损伤。
