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https://www.readbyqxmd.com/read/28885118/stereotactic-radiosurgery-for-spetzler-martin-grade-iv-and-v-arteriovenous-malformations-an-international-multicenter-study
#1
Mohana Rao Patibandla, Dale Ding, Hideyuki Kano, Zhiyuan Xu, John Y K Lee, David Mathieu, Jamie Whitesell, John T Pierce, Paul P Huang, Douglas Kondziolka, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S Grills, Danilo Silva, Mahmoud Abbassy, Symeon Missios, Gene H Barnett, L Dade Lunsford, Jason P Sheehan
OBJECTIVE Due to the complexity of Spetzler-Martin (SM) Grade IV-V arteriovenous malformations (AVMs), the management of these lesions remains controversial. The aims of this multicenter, retrospective cohort study were to evaluate the outcomes after single-session stereotactic radiosurgery (SRS) for SM Grade IV-V AVMs and determine predictive factors. METHODS The authors retrospectively pooled data from 233 patients (mean age 33 years) with SM Grade IV (94.4%) or V AVMs (5.6%) treated with single-session SRS at 8 participating centers in the International Gamma Knife Research Foundation...
September 8, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28878048/functional-impairments-for-outcomes-in-a-randomized-trial-of-unruptured-brain-avms
#2
J P Mohr, Jessica R Overbey, Ruediger von Kummer, Marco A Stefani, Richard Libman, Christian Stapf, Michael K Parides, John Pile-Spellman, Ellen Moquete, Claudia S Moy, Eric Vicaut, Alan J Moskowitz, Kirsty Harkness, Charlotte Cordonnier, Alessandra Biondi, Emmanuel Houdart, Joachim Berkefeld, Karin J M Klijn, Xavier Barreau, Helen Kim, Andreas Hartmann
OBJECTIVE: To investigate the effects of medical vs interventional management on functional outcome in A Randomized Trial of Unruptured Brain Arteriovenous Malformations (ARUBA). METHODS: We used the initial results of a nonblinded, randomized, controlled, parallel-group trial involving adults ≥18 years of age with an unruptured brain arteriovenous malformation (AVM) to compare the effects of medical management (MM) with or without interventional therapy (IT) on functional impairment, defined by a primary outcome of death or symptomatic stroke causing modified Rankin Scale (mRS) score ≥2...
September 6, 2017: Neurology
https://www.readbyqxmd.com/read/28746939/consistency-between-targets-delineated-by-angiography-computed-tomography-and-magnetic-resonance-imaging-in-stereotactic-radiosurgery-for-arteriovenous-malformation
#3
Yu-Jie Huang, Shih-Wei Hsu, Tsair-Fwu Lee, Jih-Tsun Ho, Wu-Fu Chen
BACKGROUND: Target identification is important for radiosurgery for arteriovenous malformations (AVMs). Targets defined by different imaging modalities may be inconsistent in practice. OBJECTIVES: The goal of this study is to review and analyze the consistency between targets defined by different imaging modalities in radiosurgery for AVMs. METHODS: From March 2007 to June 2011, AVM patients for radiosurgery whose targets were delineated by angiography/computed tomography (CT)/magnetic resonance imaging (MRI) were reviewed...
2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28712909/comparison-of-grading-scales-regarding-perioperative-complications-and-clinical-outcomes-of-brain-arteriovenous-malformations-after-endovascular-therapy-a-multicenter-study
#4
Hengwei Jin, Yuhua Jiang, Huijian Ge, Jing Luo, Conghui Li, Hongxing Wu, Youxiang Li
OBJECTIVES: Several scales have been proposed for risk assessment and outcome determination in brain arteriovenous malformations (bAVMs) treated by endovascular therapy. We aim to validate and compare the efficacy of these scales in predicting perioperative complications and clinical outcomes. METHODS: We retrospectively reviewed bAVM patients who underwent endovascular therapy at 4 centers in China from January 2012 to December 2015. The primary outcomes were complications, unfavorable outcome (mRS≥3) and complete obliteration...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28675345/transvenous-retrograde-avm-embolization-indications-techniques-complications-and-outcomes
#5
Xianli Lv, Cao Song, Hongwei He, Chuhan Jiang, Youxiang Li
Objective Transvenous retrograde arteriovenous malformation (AVM) embolization (TRAE) has been proposed. The present study was to review the techniques, their conjunctions and effectiveness. Methods Eligible related articles were identified by searching the PubMed and Web of Science databases using "transvenous" and "arteriovenous malformation." Results A total of 16 eligible studies, with 60 cases of AVM treated with TRAE, were analyzed. Prior to TRAE procedure, transarterial Onyx 18 was performed in 23 (38...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28669271/lateral-parietal-arteriovenous-malformation-with-feeding-artery-aneurysm
#6
Ashish H Shah, Anthony C Wang, Jacques J Morcos
Superficial arteriovenous malformations (AVMs) with favorable Spetzler-Martin grading are amenable to primary surgical resection. Careful preoperative workup including preoperative angiograms is essential to identify feeding artery aneurysms and deep venous drainage. The authors present a 37-year-old female who presented with a Spetzler-Martin Grade II right parietal superficial AVM with a 5-mm feeding artery aneurysm from the posterior cerebral artery. Given the risk of hemorrhage, the AVM was resected completely without any complications...
July 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28669267/microsurgical-resection-of-a-high-grade-occipital-arteriovenous-malformation-after-staged-embolization
#7
Liyong Sun, Hongqi Zhang, Jian Ren
The authors demonstrate the case of a 16-year-old girl with a large symptomatic occipital arteriovenous malformation (AVM). The staged embolization was performed to downgrade the AVM from Spetzler-Martin (S-M) Grade IV (Supplementary S-M Grade 7) to Grade III (Supplementary S-M Grade 5). The patient developed a subacute progressive visual field defect after the final time of embolization. MRI revealed an enlarged draining venous ectasia of the AVM compressing the visual cortex. Postoperatively, good radiological results were achieved, and the patient reported an improvement in her symptoms...
July 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28669266/navigation-guided-transsylvian-approach-and-microsurgical-resection-of-a-deep-left-temporal-low-grade-arteriovenous-malformation
#8
William T Couldwell
This video demonstrates stereotactic-guided resection of a ruptured diffuse left temporal arteriovenous malformation (AVM) in an adolescent male who presented with headache and speech difficulties. The diffuse nidus of the AVM, 25 mm in size, was located in the posterior superior temporal gyrus, with drainage into the sylvian veins (Spetzler-Martin Grade II). The AVM was located stereotactically, and resection was performed through a small corticectomy. The clot cavity was evacuated. Feeding branches to the AVM were identified during careful dissection, and parent M1 and M2 branches were preserved...
July 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28669265/contralateral-transcallosal-resection-of-a-ventricular-body-arteriovenous-malformation-3d-operative-video
#9
Brian P Walcott, Jae Seung Bang, Omar Choudhri, Sirin Gandhi, Halima Tabani, Arnau Benet, Michael T Lawton
A 46-year-old male presented with an incidentally discovered left ventricular body arteriovenous malformation (AVM). It measured 2 cm in diameter and had drainage via an atrial vein into the internal cerebral vein (Spetzler-Martin Grade III, Supplementary Grade 4). Preoperative embolization of the posterior medial choroidal artery reduced nidus size by 50%. Subsequently, he underwent a right-sided craniotomy for a contralateral transcallosal approach to resect the AVM. This case demonstrates strategic circumferential disconnection of feeding arteries (FAs) to the nidus, the use of aneurysm clips to control large FAs, and the use of dynamic retraction and importance of a generous callosotomy...
July 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28669264/surgical-treatment-of-a-complex-grade-iii-spetzler-martin-posterior-temporal-arteriovenous-malformation
#10
Amrit Chiluwal, Amir R Dehdashti
Grade III Spetzler-Martin arteriovenous malformations (AVMs) are a distinct subgroup of brain AVMs. Their variety in terms of location, type of venous drainage, and size makes them the most heterogenous group in the AVM classification. The surgical risk of treatment is also variable depending on the specifics of a given Grade III AVM. In this video illustration, the authors describe the technical nuances of surgical resection of a very complex Grade III left posterior temporal AVM. According to supplementary grading, the unruptured aspect and patient age give this lesion a Grade III; therefore, the combined grading gives the patient a score of 6, which puts him at moderate risk of morbidity for surgery...
July 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28652950/highlights-on-cerebral-arteriovenous-malformation-treatment-using-combined-embolization-and-stereotactic-radiosurgery-why-outcomes-are-controversial
#11
REVIEW
Faustina N A Sackey, Nathaneal R Pinsker, Benjamin N Baako
Cerebral arteriovenous malformations (AVMs) are abnormal tangling between brain arteries and veins causing an arteriovenous shunt called nidus with an intervening network of vessels from the region of formation and spans through the brain. AVM effect is debilitating to the affected individual due to associated persistent intracerebral hemorrhage, resulting in significant occurrences of seizures and neurological damage. Recent innovative treatments involve a combination of embolization (Embo) procedures followed by stereotactic radiosurgery (SRS), designed to optimize less-invasive practice for the obliteration of the AVMs...
May 22, 2017: Curēus
https://www.readbyqxmd.com/read/28600483/extending-the-indications-for-transvenous-approach-embolization-for-superficial-brain-arteriovenous-malformations
#12
Dinark Conceição Viana, Luis Henrique de Castro-Afonso, Guilherme Seizem Nakiri, Lucas Moretti Monsignore, Felipe Padovani Trivelato, Benedicto Oscar Colli, Daniel Giansante Abud
INTRODUCTION: Transarterial embolization is the standard endovascular treatment strategy for intracranial arteriovenous malformations (AVMs). The transvenous approach has been indicated for the embolization of deep AVMs meeting a set of strict eligibility criteria. The present study aims to assess the safety and efficacy of the transvenous approach for superficial AVMs. METHODS: A retrospective series of 12 patients presenting with cortical AVMs were treated by endovascular embolization using a transvenous approach with a curative intent...
June 9, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28565984/novel-use-of-flow-diversion-for-the-treatment-of-aneurysms-associated-with-arteriovenous-malformations
#13
Craig Kilburg, Philipp Taussky, M Yashar S Kalani, Min S Park
The use of flow-diverting stents for intracranial aneurysms has become more prevalent, and flow diverters are now routinely used beyond their initial scope of approval at the proximal internal carotid artery. Although flow diversion for the treatment of cerebral aneurysms is becoming more commonplace, there have been no reports of its use to treat flow-related cerebral aneurysms associated with arteriovenous malformations (AVMs). The authors report the cases of 2 patients whose AVM-associated aneurysms were managed with flow diversion...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28555270/critical-review-of-brain-avm-surgery-surgical-results-and-natural-history-in-2017
#14
REVIEW
Michael Kerin Morgan, Andrew Stewart Davidson, Nazih N A Assaad, Marcus Andrew Stoodley
BACKGROUND: An understanding of the present standing of surgery, surgical results and the role in altering the future morbidity and mortality of untreated brain arteriovenous malformations (bAVMs) is appropriate considering the myriad alternative management pathways (including radiosurgery, embolization or some combination of treatments), varying risks and selection biases that have contributed to confusion regarding management. The purpose of this review is to clarify the link between the incidence of adverse outcomes that are reported from a management pathway of either surgery or no intervention with the projected risks of surgery or no intervention...
August 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28525927/differences-in-functional-outcome-across-subtypes-with-spetzler-martin-grade-ii-arteriovenous-malformations
#15
Alice L Hung, Wuyang Yang, Erick M Westbroek, Tomas Garzon-Muvdi, Justin M Caplan, Maria Braileanu, Joanna Y Wang, Geoffrey P Colby, Alexander L Coon, Rafael J Tamargo, Judy Huang
No abstract text is available yet for this article.
June 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28502562/grade-1-spetzler-and-martin-cerebral-ruptured-arteriovenous-malformations-treated-by-microsurgery-poor-functional-outcome-is-related-to-injury-from-haemorrhage
#16
R Aboukaïs, M Quidet, M Baroncini, P Bourgeois, X Leclerc, M Vinchon, J-P Lejeune
INTRODUCTION: Ruptured arteriovenous malformations (rAVM) are life-threatening diseases. OBJECTIVE: To evaluate the outcome of patients with grade 1 SPM rAVM after microsurgical treatment. MATERIALS AND METHOD: We retrospectively included 64 consecutive operated patients with a grade 1 SPM rAVM in our institution between 2002 and 2012. Complications related to the surgical procedure were recorded. All patients were re-evaluated 3months after treatment using the modified Rankin Scale score (mRS)...
May 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28495425/volume-staged-stereotactic-radiosurgery-for-large-intracranial-arteriovenous-malformations
#17
Adeel Ilyas, Dale Ding, H Robert Hixson, Zhiyuan Xu, Robert M Starke, Jason P Sheehan
Stereotactic radiosurgery (SRS) is an effective treatment option for intracranial arteriovenous malformations (AVM). However, the treatment of large AVMs (nidus volume ≥12cm(3)) with single-session SRS alone yields generally poor outcomes. Volume-staged SRS (VS-SRS) is a therapeutic strategy for large AVMs which seeks to avoid the disadvantages of single-session SRS, but reports regarding its efficacy remain limited. The aim of this retrospective cohort study is to assess the outcomes of VS-SRS for large AVMs...
May 8, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28484523/radiosurgery-in-treatment-of-cerebral-arteriovenous-malformation-mid-term-results-of-388-cases-from-a-single-center
#18
Mohammad Ali Bitaraf, Ramon Katoozpour, Mazyar Azar, Mohsen Nouri, Seyed Abolghasem Mortazavi, Abbas Amirjamshidi
BACKGROUND AND OBJECTIVES: The purpose of this study is to evaluate the outcome and risks of radiosurgery for patients with arteriovenous malformations (AVM) of the brain all treated in a single center in the 3(rd) world with all its limitations. MATERIALS AND METHODS: We performed a retrospective analysis of 388 patients with AVM treated with radiosurgery during an 8-year period. Factors associated with increased chance of AVM obliteration or hemorrhages during the follow-up period were analyzed...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28458878/rendering-a-ruptured-arteriovenous-malformation-more-susceptible-to-spontaneous-obliteration-as-a-possible-treatment-strategy-for-cerebral-avm
#19
Szu-Kai Hsu, Chih-Ju Chang, I-Chang Su
Spontaneous regression of cerebral arteriovenous malformation (AVM) is a rare phenomenon, but its occurrence is an important consideration in treatment planning. A 58-year-old male was found to have a high-flow AVM of Spetzler-Martin Grade III. Before his scheduled treatment, the AVM ruptured with a large parenchymal hemorrhage. Following emergency decompressive surgery, a targeted embolization procedure was performed to obliterate the ruptured weak point and to reduce the shunting flow. The residual AVM became a malformation harboring angio-architectural factors favoring spontaneous obliteration...
April 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28457930/delayed-venous-drainage-in-ruptured-arteriovenous-malformations-based-on-quantitative-color-coded-digital-subtraction-angiography
#20
Jan-Karl Burkhardt, Xiaolin Chen, Ethan A Winkler, Daniel L Cooke, Helen Kim, Michael T Lawton
OBJECTIVE: Clinically applicable hemodynamic risk factors to predict arteriovenous malformation (AVM) rupture are missing in the literature. The aim of this study was to use catheter angiography to identify hemodynamic parameters in ruptured and unruptured AVMs. METHODS: Patients with frontal and temporal AVMs and Siemens syngo iFlow color-coding angiography were included in this study (n = 71). Clinical and radiologic data (age, sex, Spetzler-Martin [SM] and supplemented SM grade, and rupture status), and hemodynamic features (contrast mean transit time [MTT] of feeding arteries, draining veins, AVM nidus, and the cerebral circulation time [CCT]) were analyzed...
August 2017: World Neurosurgery
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