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https://www.readbyqxmd.com/read/27911249/international-multicenter-cohort-study-of-pediatric-brain-arteriovenous-malformations-part-2-outcomes-after-stereotactic-radiosurgery
#1
Robert M Starke, Dale Ding, Hideyuki Kano, David Mathieu, Paul P Huang, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S Grills, Danilo Silva, Mahmoud Abbassy, Symeon Missios, Douglas Kondziolka, Gene H Barnett, L Dade Lunsford, Jason P Sheehan
OBJECTIVE Pediatric patients (age < 18 years) harboring brain arteriovenous malformations (AVMs) are burdened with a considerably higher cumulative lifetime risk of hemorrhage than adults. Additionally, the pediatric population was excluded from recent prospective comparisons of intervention versus conservative management for unruptured AVMs. The aims of this multicenter, retrospective cohort study are to analyze the outcomes after stereotactic radiosurgery for unruptured and ruptured pediatric AVMs. METHODS We analyzed and pooled AVM radiosurgery data from 7 participating in the International Gamma Knife Research Foundation...
December 2, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27903925/onyx-extravasation-during-embolization-of-a-brain-arteriovenous-malformation
#2
Hiroyuki Ikeda, Hirotoshi Imamura, Yuji Agawa, Yukihiro Imai, Shoichi Tani, Hidemitsu Adachi, Tatsuya Ishikawa, Yohei Mineharu, Nobuyuki Sakai
During Onyx embolization to treat brain arteriovenous malformation (AVM), carefully observing the penetration of Onyx to the nidus is important in order to avoid complications such as hemorrhage, ischemia, and difficulty with microcatheter removal. We encountered a case of Onyx extravasation during embolization of a cerebellar AVM confirmed by surgical resection and pathological analysis. The patient was a 44-year-old man with Spetzler-Martin grade I cerebellar AVM who underwent Onyx embolization prior to resection of the brain AVM...
November 30, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27899758/estimating-the-risks-of-adverse-radiation-effects-after-gamma-knife-radiosurgery-for-arteriovenous-malformations
#3
Hideyuki Kano, John C Flickinger, Daniel Tonetti, Alan Hsu, Huai-Che Yang, Thomas J Flannery, Ajay Niranjan, L Dade Lunsford
BACKGROUND AND PURPOSE: We evaluated risk factors associated with the development of adverse radiation effects (ARE) after stereotactic radiosurgery (SRS) for cerebral arteriovenous malformations (AVMs). METHODS: We evaluated 755 patients with AVM who underwent a single Gamma Knife SRS procedure with at least a 2-year minimum follow-up. Eighty-seven patients (12%) underwent previous resection and 128 (17%) had previous embolization. The median target volume was 3...
November 29, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27856955/microsurgery-for-aruba-trial-a-randomized-trial-of-unruptured-brain-arteriovenous-malformation-eligible-unruptured-brain-arteriovenous-malformations
#4
Johnny Wong, Alana Slomovic, George Ibrahim, Ivan Radovanovic, Michael Tymianski
BACKGROUND AND PURPOSE: The management of unruptured brain arteriovenous malformations (ubAVMs) remains controversial despite ARUBA trial (A Randomized Trial of Unruptured Brain Arteriovenous Malformation), a controlled trial that suggested superiority of conservative management over intervention. However, microsurgery occurred in only 14.9% of ARUBA intervention cases, raising concerns about the study's generalizability. Our purpose was to evaluate whether, in a larger ARUBA-eligible ubAVM population, microsurgery produces acceptable outcomes...
November 17, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27835916/neuropsychological-performance-after-brain-arteriovenous-malformations-treatment
#5
Ondrej Bradac, Alice Pulkrabkova, Patricia de Lacy, Vladimir Benes
Background The treatment of brain arteriovenous malformations (AVMs) has been studied extensively. With the use of the Spetzler-Martin (S-M) grading system, patients can be informed appropriately about their possible surgical risks. This does not hold true for their neuropsychological sequelae, which have not been studied widely. We evaluated the neuropsychological outcome of our patients treated for brain AVMs. Methods Of 113 patients treated for a brain AVM between 2001 and 2009, 66 patients were enrolled in the study...
November 11, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/27821297/validity-assessment-of-grading-scales-predicting-complications-from-embolization-of-cerebral-arteriovenous-malformations
#6
Raghav Gupta, Nimer Adeeb, Justin M Moore, Rouzbeh Motiei-Langroudi, Christoph J Griessenauer, Apar S Patel, Christopher S Ogilvy, Ajith J Thomas
OBJECTIVE: Endovascular embolization, though initially approved as an adjunctive therapy for surgical excision of cerebral arteriovenous malformations (AVMs), has found extensive use in the management of these lesions. A number of systems have been proposed to stratify AVMs by the procedural risk of embolization, including the Buffalo score and AVM Neuroendovascular grade. An external validity assessment of these systems has not been performed. PATIENTS AND METHODS: A retrospective review of all patients who underwent embolization of cerebral AVMs at a single institution, between 2010 and 2016, was performed...
December 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27790398/preoperative-embolization-of-cerebral-arteriovenous-malformations-with-silk-suture-and-particles-technical-considerations-and-outcomes
#7
Jordan R Conger, Dale Ding, Daniel M Raper, Robert M Starke, Christopher R Durst, Kenneth C Liu, Mary E Jensen, Avery J Evans
OBJECTIVE: Embolization of cerebral arteriovenous malformations (AVMs) is commonly performed prior to surgical resection in order to reduce intraoperative bleeding and improve the safety of resection. Although most modern embolization procedures utilize permanent embolic agents, silk suture and polyvinyl alcohol (PVA) particles may offer unique advantages for preoperative devascularization. The aims of this retrospective cohort study are to describe the technical considerations and determine the outcomes for preoperative silk suture and PVA particle embolization (SPE) of AVMs...
June 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27767404/prevalence-and-characteristics-of-brain-arteriovenous-malformations-in-hereditary-hemorrhagic-telangiectasia-a-systematic-review-and-meta-analysis
#8
Waleed Brinjikji, Vivek N Iyer, Christopher P Wood, Giuseppe Lanzino
OBJECTIVE Patients with hereditary hemorrhagic telangiectasia (HHT) are known to suffer from high rates of cerebral arteriovenous malformations (AVMs). The authors performed a systematic review and meta-analysis of the literature examining prevalence rates, characteristics, and clinical presentation of cerebral AVMs in the HHT population. METHODS To identify studies on AVM prevalence and characteristics in the HHT population, 4 databases (MEDLINE, EMBASE, Scopus and Web of Science) were searched by a reference librarian with over 30 years experience in systematic reviews and meta-analysis...
October 21, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27766428/multiple-cerebral-arterio-venous-malformations-impact-of-multiplicity-and-hemodynamics-on-treatment-strategies
#9
Klaus-Peter Stein, Isabel Wanke, Neriman Oezkan, Yuan Zhu, I Erol Sandalcioglu, Michael Forsting, Ulrich Sure
BACKGROUND: Multiple AVMs are exceptionally rare lesions and only a few larger series have been published, including other vascular pathologies, such as arterio-venous fistulae (AVF) or patients with hereditary syndromes. Our study presents clinical, angiographic, and therapeutic characteristics of patients harboring sporadic multiple AVMs. METHODS: Basic demographic data, vascular architecture, clinical presentation, treatment strategies, and treatment outcome were analyzed retrospectively from patients with cerebral AVMs treated in our department between 1990 and 2015...
October 20, 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27760058/time-of-arrival-parametric-maps-and-virtual-bolus-images-derived-from-contrast-enhanced-time-resolved-radial-magnetic-resonance-angiography-improve-the-display-of-brain-arteriovenous-malformation-vascular-anatomy
#10
Tilman Schubert, Yijing Wu, Kevin M Johnson, Oliver Wieben, Jane Maksimovic, Charles Mistretta, Patrick Turski
OBJECTIVES: Time-of-arrival (TOA) maps can be derived from high-resolution 4-dimensional (4D) contrast-enhanced magnetic resonance angiography (MRA) data sets to provide a quantitative description of contrast material arrival time in each voxel. This information can further be processed to create a compressed time evolution curve that virtually shortens the contrast bolus (virtual bolus [VB]). The purpose of this project was to determine whether TOA-enhanced 4D MRA and/or VB imaging improve the display of contrast kinetics in patients with vascular disease...
November 2016: Investigative Radiology
https://www.readbyqxmd.com/read/27757503/predictors-for-occlusion-of-cerebral-avms-following-radiation-therapy-radiation-dose-and-prior-embolization-but-not-spetzler-martin-grade
#11
Stefan Knippen, Florian Putz, Sabine Semrau, Ulrike Lambrecht, Arzu Knippen, Michael Buchfelder, Sven Schlaffer, Tobias Struffert, Rainer Fietkau
BACKGROUND: Intracranial arteriovenous malformations (AVMs) may show a harmful development. AVMs are treated by surgery, embolization, or radiation therapy. OBJECTIVE: This study investigated obliteration rates and side effects in patients with AVMs treated by radiation therapy. METHODS: A total of 40 cases treated between 2005 and 2013 were analyzed. Single-dose stereotactic radiosurgery (SRS) was received by 13 patients and 27 received hypofractionated stereotactic radiation therapy (HSRT)...
October 18, 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/27689461/stereotactic-radiosurgery-for-cerebellar-arteriovenous-malformations-an-international-multicenter-study
#12
Or Cohen-Inbar, Robert M Starke, Hideyuki Kano, Gregory Bowden, Paul Huang, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S Grills, David Mathieu, Danilo Silva, Mahmoud Abbassy, Symeon Missios, John Y K Lee, Gene H Barnett, Douglas Kondziolka, L Dade Lunsford, Jason P Sheehan
OBJECTIVE Cerebellar arteriovenous malformations (AVMs) represent the majority of infratentorial AVMs and frequently have a hemorrhagic presentation. In this multicenter study, the authors review outcomes of cerebellar AVMs after stereotactic radiosurgery (SRS). METHODS Eight medical centers contributed data from 162 patients with cerebellar AVMs managed with SRS. Of these patients, 65% presented with hemorrhage. The median maximal nidus diameter was 2 cm. Favorable outcome was defined as AVM obliteration and no posttreatment hemorrhage or permanent radiation-induced complications (RICs)...
September 30, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27509452/gamma-knife-radiosurgery-for-arteriovenous-malformations-clinical-series-of-199-patients
#13
Ipek Arslan, Evrim Tezcanli, Meltem Yilmaz, Olcay Cizmeli, Meric Sengoz, Selcuk Peker
AIM: Cerebral arteriovenous malformations (AVM) are pathological connections between arteries and veins without capillaries. Stereotactic radiosurgery (RS) is a proven and accepted treatment method for cerebral AVMs. Our objective was to analyze the factors influencing the clinical outcome in patients suffering from AVMs. MATERIAL AND METHODS: We retrospectively reviewed 199 patients who were treated with Gamma-Knife RS for intracranial AVMs between 13 October 2005 and 31 October 2010...
September 21, 2015: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27473023/rapid-spontaneous-obliteration-of-intracranial-arteriovenous-malformation
#14
William R Stetler, Adam J Polikfa, W Christopher Fox, Brian Hoh
A 35-year-old male presented with headaches and was found to have a Spetzler-Martin grade 2 right occipital arteriovenous malformation (AVM) with single, superficial draining vein. The patient opted to undergo embolization for possible cure with resection scheduled in the event complete obliteration was not achieved. Three weeks later, angiography during his embolization procedure revealed that the AVM had spontaneously obliterated; no treatment was required. In conjunction with prior case reports/series, this patient highlights the need for current imaging prior to proceeding with intervention to confirm that spontaneous obliteration has not occurred between diagnosis and treatment...
July 26, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27446926/the-role-of-preradiosurgical-embolization-in-the-management-of-grades-iii-iv-and-v-arteriovenous-malformations
#15
Evandro C Sousa, Manoel J Teixeira, Ronnie L Piske, Lavoisier S Albuquerque, Sebastião Côrrea, Salomão Benabou, Leonardo C Welling, Leonardo Moura de Sousa, Eberval Gadelha Figueiredo
OBJECTIVE: To evaluate the role of preradiosurgical embolization on obliteration rate, reduction of size, irradiation dose, and neurological outcome, in 90 patients presenting large arteriovenous malformations (AVMs). METHODS: Between October 1993 and October 2006, 90 radiosurgical procedures were performed to treat brain AVMs Spetzler-Martin (SM) grades III, IV, and V at the Department of Radiosurgery and Radiology of the Real e Benemérita Associação Portuguesa de Beneficência de São Paulo, São Paulo, Brazil...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27430471/endovascular-treatment-of-arteriovenous-malformations
#16
Orlando Diaz, Robert Scranton
Cerebral arteriovenous malformations (AVM) are tangles of blood vessels that permit shunting of blood from the arterial to venous phase without intervening capillaries. The malformation's arterialization of a low-pressure system creates a risk of rupture that is substantially higher when associated with an aneurysm. The annual hemorrhage rate is 2.2% per year as reported in the randomized trial of unruptured brain AVMs (ARUBA; rupture risk is increased after the first event. Ruptured AVMs have a 10% mortality rate and 20%-30% morbidity rate...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27423196/treatment-of-cerebral-arteriovenous-malformations-with-radiosurgery-or-hypofractionated-stereotactic-radiotherapy-in-a-consecutive-pooled-linac-series
#17
Jan P Boström, Ruth Bruckermann, Bogdan Pintea, Azize Boström, Gunnar Surber, Klaus Hamm
OBJECTIVE: To review outcomes after LINAC stereotactic radiosurgery (SRS) and hypofractionated stereotactic radiotherapy (hfSRT) of arteriovenous malformations (AVM) from a consecutive and pooled series of two Novalis® centers and to analyse influence of AVM size, Spetzler-Martin (SM) grade, pre-treatment, and hemorrhagic vs. non-hemorrhagic presentation. A subgroup analysis of ARUBA eligible patients was additionally performed. METHODS: Prospectively collected treatment and outcome data were supplemented by retrospectively collected follow-up (FU) data for 93...
July 13, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27367242/effect-of-functional-mri-guided-navigation-on-surgical-outcomes-a-prospective-controlled-trial-in-patients-with-arteriovenous-malformations
#18
Fuxin Lin, Yuming Jiao, Jun Wu, Bing Zhao, Xianzeng Tong, Zhen Jin, Yong Cao, Shuo Wang
OBJECTIVE The impact of functional MRI (fMRI)-guided navigation on the surgical outcome of patients with arteriovenous malformations (AVMs) is undetermined. This large, randomized controlled trial (RCT) was designed to determine the safety and efficacy of fMRI-guided microsurgery of AVMs. This paper reports the preliminary results of the interim analysis. METHODS Between September 2012 and June 2015, eligible patients were randomized to the standard microsurgery group (control group) or the fMRI-guided surgery group (experimental group) in a 1:1 ratio...
July 1, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27366251/the-focus-on-aneurysm-principle-classification-and-surgical-principles-of-management-of-concurrent-arterial-aneurysm-with-arteriovenous-malformation-causing-intracranial-hemorrhage
#19
Vikas Jha, Sanjay Behari, Awadhesh K Jaiswal, Kamlesh Singh Bhaisora, Yogesh P Shende, Rajendra V Phadke
CONTEXT: Concurrent arterial aneurysms (AAs) occurring in 2.7-16.7% patients harboring an arteriovenous malformation (AVM) aggravate the risk of intracranial hemorrhage. AIM: We evaluate the variations of aneurysms simultaneously coexisting with AVMs. A classification-based management strategy and an abbreviated nomenclature that describes their radiological features is also proposed. SETTING: Tertiary care academic institute. STATISTICS: Test of significance applied to determine the factors causing rebleeding in the groups of patients with concurrent AVM and aneurysm and those with only AVMs...
July 2016: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/27345834/lesion-to-eloquent-fiber-distance-is-a-crucial-risk-factor-in-presurgical-evaluation-of-arteriovenous-malformations-in-the-temporo-occipital-junction
#20
Yuming Jiao, Fuxin Lin, Jun Wu, Hao Li, Lijun Wang, Zhen Jin, Shuo Wang, Yong Cao
OBJECTIVE: Temporo-occipital junction arteriovenous malformations (TOJ-AVMs) do not often involve eloquent brain cortex, but rather exist beside functional fiber tracts. The objective of this study was to determine the outcomes after surgical treatment in patients with TOJ-AVMs and to identify risk factors associated with postoperative neurologic deficits. METHODS: We retrospectively studied 41 patients with TOJ-AVMs. All patients underwent preoperative diffusion tensor imaging...
September 2016: World Neurosurgery
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