Objective To compare the application effect and safety of simple microsurgery, simple interventional embolization, versus combined surgery in children with deep cerebral arteriovenous malformation (dAVM). Methods A retrospective analysis was adopted to identify the clinical data of 69 children with dAVM, and they were divided into simple interventional embolization group (n=26), simple microsurgery group (n=24) or combined surgery group (with the sequential regimen of firstly receiving interventional embolization and then microsurgery, n=19) according to surgical methods. Intraoperative bleeding volume and length of hospital stay were compared between the three groups. The modified Rankin Scale (mRS) was used to evaluate neurological function and daily activity ability before surgery, on the day after surgery, and 1 week after surgery. Muscle strength grading was performed before surgery and 1 week after surgery adopting the clinical general muscle strength evaluation standard. Digital subtraction angiography was reexamined 3 months after surgery to evaluate the curative effect. Results The intraoperative bleeding volume and length of hospital stay in the simple interventional embolization group and the combined surgery group were less or shorter than those in the simple microsurgery group (P<0.05). On the day after surgery and 1 week after surgery, the simple microsurgery group and the combined surgery group exhibited lower scores of mRS as compared with the simple interventional embolization group, and the combined surgery group yielded a lower mRS score as compared with the simple microsurgery group (P<0.05). All 3 groups interpreted lower mRS scores 1 week after surgery as compared with before surgery (P<0.05). One week after surgery, muscle strength grading was higher in the simple interventional embolization group and the combined surgery group than in the simple microsurgery group, and higher in the combined surgery group than in the simple interventional embolization group (P<0.05). The combined surgery group depicted a higher complete occlusion rate to compare with the simple microsurgery group (P<0.05), whereas there was no statistically significant difference in the complete occlusion rate between the combined surgery group and the simple interventional embolization group, and between the simple interventional embolization group and the simple microsurgery group (P>0.05). Conclusion Compared with simple microsurgery or interventional embolization, sequential regimen of firstly receiving interventional embolization and then microsurgery has significant advantages in the treatment of dAVM children, which can effectively reduce intraoperative bleeding volume, shorten length of hospital stay, promote postoperative neurological function recovery, improve limb muscle strength, and improve the curative effect.

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