{"_buckets": {"deposit": "1d07d1cd-1ce4-4120-9af5-4a959b619435"}, "_deposit": {"id": "9229", "owners": [], "pid": {"revision_id": 0, "type": "depid", "value": "9229"}, "status": "published"}, "_oai": {"id": "oai:nagoya.repo.nii.ac.jp:00009229"}, "item_10_alternative_title_19": {"attribute_name": "\u305d\u306e\u4ed6\u306e\u8a00\u8a9e\u306e\u30bf\u30a4\u30c8\u30eb", "attribute_value_mlt": [{"subitem_alternative_title": "Effectiveness and Pitfall of Embolization for Cerebral Arteriovenous Malformations"}]}, "item_10_biblio_info_6": {"attribute_name": "\u66f8\u8a8c\u60c5\u5831", "attribute_value_mlt": [{"bibliographicIssueDates": {"bibliographicIssueDate": "2005-06", "bibliographicIssueDateType": "Issued"}, "bibliographicIssueNumber": "6", "bibliographicPageEnd": "400", "bibliographicPageStart": "393", "bibliographicVolumeNumber": "14", "bibliographic_titles": [{"bibliographic_title": "\u8133\u795e\u7d4c\u5916\u79d1\u30b8\u30e3\u30fc\u30ca\u30eb"}]}]}, "item_10_description_4": {"attribute_name": "\u6284\u9332", "attribute_value_mlt": [{"subitem_description": "\u8133\u52d5\u9759\u8108\u5947\u5f62(AVM)\u306e\u6839\u6cbb\u7684\u6cbb\u7642\u3068\u3057\u3066\u306e\u6458\u51fa\u8853\u304a\u3088\u3073radiosurgery\u306e\u8853\u524d\u51e6\u7f6e\u3068\u3057\u3066\u306e\u8840\u7ba1\u5185\u6cbb\u7642(\u585e\u6813\u8853) \u306f, \u4ee5\u524d\u3088\u308a\u9700\u8981\u306f\u6e1b\u5c11\u3057\u3066\u3044\u308b\u304c, \u4f9d\u7136\u3068\u3057\u3066high grade AVM\u306b\u5bfe\u3059\u308b\u4f4d\u7f6e\u3065\u3051\u306f\u9ad8\u304f, \u7279\u306b(1)nidus\u306e\u7e2e\u5c0f\u3068\u8840\u6d41\u306e\u6e1b\u5c11, (2)\u5f8c\u6cbb\u7642\u306b\u4e0d\u9069\u5207\u306a\u8981\u7d20\u306e\u6392\u9664, (3)\u4ed8\u968f\u3059\u308b\u52d5\u8108\u7624\u306e\u51e6\u7f6e\u306e3\u70b9\u306b\u3064\u3044\u3066\u306f\u585e\u6813\u8853\u306e\u679c\u305f\u3059\u5f79\u5272\u306f\u5927\u304d\u3044.\u307e\u305f\u907a\u6b8b, \u518d\u767a\u4f8b\u306b\u5bfe\u3057\u3066\u3082\u4f4e\u4fb5\u8972\u3067\u3042\u308b\u585e\u6813\u8853\u306e\u6709\u7528\u6027\u304c\u3042\u308b.\u585e\u6813\u8853\u306e\u57fa\u672c\u7684\u306a\u8003\u3048\u65b9\u306f, \u4e0d\u5341\u5206\u306a\u6cbb\u7642\u3067\u3042\u3063\u3066\u3082\u6700\u7d42\u6cbb\u7642\u307e\u3067\u306b\u75c7\u72b6\u5897\u60aa\u3084\u51fa\u8840\u3092\u304d\u305f\u3055\u306a\u3044\u3053\u3068\u3067\u3042\u308b.\u305d\u306e\u305f\u3081\u306b\u306f\u3055\u307e\u3056\u307e\u306a\u8a3a\u65ad\u30c4\u30fc\u30eb\u3084\u30c6\u30b9\u30c8\u306e\u6d3b\u7528\u306b\u3088\u308b\u6a5f\u80fd\u7684\u8840\u7ba1\u89e3\u5256\u306e\u7406\u89e3, \u5f8c\u6cbb\u7642\u306b\u5bfe\u5fdc\u3059\u308b\u8840\u7ba1\u5185\u624b\u8853\u30c7\u30b6\u30a4\u30f3, \u518d\u958b\u901a\u4e88\u9632\u306e\u305f\u3081\u306enidus embolization, \u5371\u6a5f\u7ba1\u7406\u306b\u57fa\u3065\u304f\u5468\u8853\u671f\u30b1\u30a2\u304c\u5fc5\u8981\u3067\u3042\u308b. The use of embolization for cerebral arteriovenous malformations (AVMs) as the pretreatment of surgical extirpation and radiosurgery has recently diminished due to the passive application to asymptomatic patients and growing preference for radiosurgery based on its superior results. However, the embolization still plays an important role in some difficult AVMs. It is particularly significant in terms of the following : (1) reduction of nidus size and shunt flow, (2) elimination of inappropriate factors so as to achieve the maximum effect of the secondary treatments, (3) treatment for associated aneurysms posing high risk of rupture. The basic concept of AVM embolization is not to pursue total AVM obstruction by embolization alone but to avoid rebleeding and deteriorations of symptoms by targeted embolization. To perform a safe and effective embolization, the following points are thought to be very important : (1) understanding the angioarchitecture of the functional brain using various functional imagings and provocative tests, (2) an embolization design and strategy proportionate to the secondary treatments, (3) nidus embolization with materials that pose the least risk of recanalization, and (4) assuring appropriate perioperative care based on the principles of risk management. In spite of taking such precautions the rate of compcliaions was 13.9%, and the morbid-mortality rate was 4.9% in our series. Two patients with an angiographic cure of temporooccipital AVMs suffered from extensive intracerebral bleeding 6 and 8 years after radiosurgery. 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