Angiographic complications during stereotactic radiosurgery for cerebral arteriovenous malformations.

During the past 20 years, stereotactic radiosurgery in the form of a multisource cobalt-60 gamma knife has been used to treat more than 1500 selected cases of intracranial arteriovenous malformations (AVMs) worldwide (1-5). Precise three-dimensional localization of the target volume is required for computer planning and radiation dose determination (6). Although either computed tomography (CT) or magnetic resonance (MR) imaging can be used for tumors, angiography is necessary for A V Ms. Neither the stereotactic frame attached to each patient's head nor the adapter used for fixation of the headframe to the angiographic table is completely radiolucent (Fig. 1 ). Thus, at times during fluoroscopy the catheters and guidewires can be obscured, potentially increasing the complications. In order to assess this risk, we reviewed our 3-year experience in stereotactic angiography and compared it to our experience with routine diagnostic cerebral angiography performed over the same time period.