Transvenous Embolization of Brain Arteriovenous Malformations: Up-to-Date Meta-Analysis

AIM: To conduct an up-to-date meta-analysis to assess the success and complication rates of transvenous embolization (TVE) of brain arteriovenous malformations (BAVMs), and to determine its efficacy and safety. MATERIAL and METHODS: Relevant and potentially relevant studies from 1982 to February 2021 were searched; after which those that satisfied our eligibility criteria and reported the main outcomes (endovascular occlusion and complication rates) were included. RESULTS: Ultimately seven studies were selected. In total, 154 patients were comprehensively reviewed for BAVMs characteristics and endovascular TVE techniques. The weighted mean rate of immediate endovascular total occlusion, overall technical complication, and overall good functional outcome (mRs < 2) were 93% (95% confidence intervals (CI), 89.1%–96.9%, I2 = 0%, p=0.487), 10.5% (95% CI, 4.3%–16.6%, I2 = 30.8%, p=0.193), and 90.9% (95% CI, 85.3%–96.6%, I2 = 26.6%, p=0.241), respectively. CONCLUSION: TVE for BAVMs was found to be generally safe and effective in certain selected patients. However, the complementary role of TAE to TVE as a definitive endovascular treatment for BAVMs cannot be separated. More studies regarding this role need to be conducted.