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Spetzler martin

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https://www.readbyqxmd.com/read/28431024/radiosurgery-for-unruptured-brain-arteriovenous-malformations-an-international-multicenter-retrospective-cohort-study
#1
Dale Ding, Robert M Starke, Hideyuki Kano, John Y K Lee, David Mathieu, John Pierce, Paul Huang, Symeon Missios, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S Grills, Danilo Silva, Mahmoud Abbassy, Douglas Kondziolka, Gene H Barnett, L Dade Lunsford, Jason P Sheehan
BACKGROUND: The role of intervention in the management of unruptured brain arteriovenous malformations (AVM) is controversial. OBJECTIVE: To analyze in a multicenter, retrospective cohort study, the outcomes following radiosurgery for unruptured AVMs and determine predictive factors. METHODS: We evaluated and pooled AVM radiosurgery data from 8 institutions participating in the International Gamma Knife Research Foundation. Patients with unruptured AVMs and ≥12 mo of follow-up were included in the study cohort...
April 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28427848/early-outcomes-and-periprocedural-complications-of-transarterial-embolization-of-brain-arteriovenous-malformations-with-onyx-%C3%A2
#2
Wojciech Poncyljusz, Marcin Sawicki, Katarzyna Lubkowska, Monika Rać
BACKGROUND: Brain arteriovenous malformation (BAVM) is a rare pathology diagnosed mostly in young adults. However, due to its hemorrhagic complications, it constitutes an important clinical problem. Treatment modalities available include endovascular, surgery and radiosurgery. The aim of the study was to assess the efficacy and safety of endovascular treatment of BAVM with Onyx(®) by reporting one-center experience. MATERIAL AND METHODS: Between 2006 and 2013, 54 patients with BAVM were embolized with Onyx...
April 5, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28419337/targeted-embolization-of-aneurysms-associated-with-brain-arteriovenous-malformations-at-high-risk-for-surgical-resection-a-case-control-study
#3
Matthew D Alexander, Daniel S Hippe, Daniel L Cooke, Danial K Hallam, Steven W Hetts, Helen Kim, Michael T Lawton, Laligam N Sekhar, Louis J Kim, Basavaraj V Ghodke
BACKGROUND: High-risk components of brain arteriovenous malformations (BAVMs) can be targeted to reduce the risk of lesion rupture. OBJECTIVE: To evaluate targeted embolization of aneurysms against other means of treatment with a case-control analysis; we previously investigated this approach associated with BAVMs. METHODS: Retrospective analysis of patients with BAVMs was performed, identifying patients treated with intention to occlude only an aneurysm associated with a BAVM...
April 13, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28408632/4d-dsa-for-dynamic-visualization-of-cerebral-vasculature-a-single-center-experience-in-26-cases
#4
S Lang, P Gölitz, T Struffert, J Rösch, K Rössler, M Kowarschik, C Strother, A Doerfler
BACKGROUND AND PURPOSE: 4D DSA allows acquisition of time-resolved 3D reconstructions of cerebral vessels by using C-arm conebeam CT systems. The aim of our study was to evaluate this new method by qualitative and quantitative means. MATERIALS AND METHODS: 2D and 4D DSA datasets were acquired in patients presenting with AVMs, dural arteriovenous fistulas, and cerebral aneurysms. 4D DSA was compared with 2D DSA in a consensus reading of qualitative and quantitative parameters of AVMs (eg, location, feeder, associated aneurysms, nidus size, drainage, Martin-Spetzler Score), dural arteriovenous fistulas (eg, fistulous point, main feeder, diameter of the main feeder, drainage), and cerebral aneurysms (location, neck configuration, aneurysmal size)...
April 13, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28389875/european-consensus-conference-on-unruptured-brain-avms-treatment-supported-by-eans-esmint-egks-and-sinch
#5
Marco Cenzato, Edoardo Boccardi, Ettore Beghi, Peter Vajkoczy, Istvan Szikora, Enrico Motti, Luca Regli, Andreas Raabe, Shalva Eliava, Andreas Gruber, Torstein R Meling, Mika Niemela, Alberto Pasqualin, Andrey Golanov, Bengt Karlsson, Andras Kemeny, Roman Liscak, Bodo Lippitz, Matthias Radatz, Alessandro La Camera, René Chapot, Civan Islak, Laurent Spelle, Alberto Debernardi, Elio Agostoni, Martina Revay, Michael K Morgan
In December of 2016, a Consensus Conference on unruptured AVM treatment, involving 24 members of the three European societies dealing with the treatment of cerebral AVMs (EANS, ESMINT, and EGKS) was held in Milan, Italy. The panel made the following statements and general recommendations: (1) Brain arteriovenous malformation (AVM) is a complex disease associated with potentially severe natural history; (2) The results of a randomized trial (ARUBA) cannot be applied equally for all unruptured brain arteriovenous malformation (uBAVM) and for all treatment modalities; (3) Considering the multiple treatment modalities available, patients with uBAVMs should be evaluated by an interdisciplinary neurovascular team consisting of neurosurgeons, neurointerventionalists, radiosurgeons, and neurologists experienced in the diagnosis and treatment of brain AVM; (4) Balancing the risk of hemorrhage and the associated restrictions of everyday activities related to untreated unruptured AVMs against the risk of treatment, there are sufficient indications to treat unruptured AVMs grade 1 and 2 (Spetzler-Martin); (5) There may be indications for treating patients with higher grades, based on a case-to-case consensus decision of the experienced team; (6) If treatment is indicated, the primary strategy should be defined by the multidisciplinary team prior to the beginning of the treatment and should aim at complete eradication of the uBAVM; (7) After having considered the pros and cons of a randomized trial vs...
April 7, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28362235/a-supplementary-grading-scale-combining-lesion-to-eloquence-distance-for-predicting-surgical-outcomes-of-patients-with-brain-arteriovenous-malformations
#6
Yuming Jiao, Fuxin Lin, Jun Wu, Hao Li, Lijun Wang, Zhen Jin, Shuo Wang, Yong Cao
OBJECTIVE Case selection for the surgical treatment of brain arteriovenous malformations (BAVMs) remains challenging. This study aimed to construct a predictive grading system combining lesion-to-eloquence distance (LED) for selecting patients with BAVMs for surgery. METHODS Between September 2012 and September 2015, the authors retrospectively studied 201 consecutive patients with BAVMs. All patients had undergone preoperative functional MRI and diffusion tensor imaging (DTI), followed by resection. Both angioarchitectural factors and LED were analyzed with respect to the change between preoperative and final postoperative modified Rankin Scale (mRS) scores...
March 31, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28355735/-clinical-application-of-hybrid-surgery-for-the-treatment-of-cerebral-arteriovenous-malformations
#7
H X Wu, Rexiti Paerhati, G J Feng, X P Yang, P Zhao, Q L Liu, G Li, X G Li, D H Wang
Objective: To investigate the application of hybrid technique for the treatment of cerebral arteriovenous malformations (CAVMs) and to assess the value of hybrid technique. Methods: The cases of CAVMs treated in Qilu hospital and People's Hospital of Xinjiang Uygur Autonomous Region from July 2011 to July 2016 were analyzed retrospectively.Two modes of hybrid surgery, "angiographic diagnosis-craniotomy lesion resection or/and hematoma clearance-intraoperative angiography evaluation" and "angiographic diagnosis-intraoperative embolization-craniotomy lesion resection or/and hematoma clearance-intraoperative angiography evaluation" were applied for all the cases...
March 21, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28351522/dynamic-conformal-arc-radiosurgery-for-arteriovenous-malformations-outcome-and-influence-of-clinical-and-dosimetrical-data
#8
Karen Clement-Colmou, Vincent Roualdes, Stéphane-André Martin, Stephanie Josset, Hubert Desal, Loïc Campion, François Thillays
PURPOSE: To assess efficacy, toxicity, and their predictive factors for dynamic conformal arc arteriovenous malformations (AVM) stereotactic radiosurgery. METHOD: Data concerning 90 consecutive patients were retrospectively studied. Clinical, radiological, dosimetrical data and quality indexes were computed. RESULTS: AVM median volume was 1.06cc. Median prescribed dose was 22Gy. Total occlusion was obtained for 69% of patients. Post-radiosurgery annual hemorrhage rate was 2...
March 25, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28344176/stereotactic-radiosurgery-for-a-randomized-trial-of-unruptured-brain-arteriovenous-malformations-aruba-eligible-spetzler-martin-grade-i-and-ii-arteriovenous-malformations-a-multicenter-study
#9
Dale Ding, Robert M Starke, Hideyuki Kano, David Mathieu, 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: A Randomized Trial of Unruptured Brain Arteriovenous Malformations (ARUBA) found better short-term outcomes after conservative management compared to intervention for unruptured arteriovenous malformations (AVM). However, since Spetzler-Martin (SM) grade I-II AVMs have the lowest treatment morbidity, sufficient follow-up of these lesions may demonstrate a long-term benefit from intervention. The aim of this multicenter, retrospective cohort study is to assess the outcomes after stereotactic radiosurgery (SRS) for ARUBA-eligible SM grade I-II AVMs...
March 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28327955/differences-in-functional-outcome-across-subtypes-with-spetzler-martin-grade-ii-arteriovenous-malformations
#10
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
BACKGROUND: The Spetzler-Martin grading system for brain arteriovenous malformations (AVMs) is based on size (S), eloquence (E), and deep venous drainage (V). However, variation exists due to subgroup heterogeneity. While previous studies have demonstrated variations in outcomes within grade III AVMs, no studies have focused on grade II AVM subtypes. OBJECTIVE: We aim to delineate how functional outcomes differ among patients with subtypes of grade II AVMs. METHODS: We retrospectively reviewed patients with AVMs evaluated at our institution from 1990 to 2013...
February 4, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28324183/multimodality-management-and-outcomes-of-brain-arterio-venous-malformations-avms-in-children-personal-experience-and-review-of-the-literature-with-specific-emphasis-on-age-at-first-avm-bleed
#11
REVIEW
Anan Shtaya, John Millar, Owen Sparrow
PURPOSE: The purpose of this paper is to study the presentation and analyse the results of multimodality treatment of brain arterio-venous malformations (AVMs) in children at our centre and review age at first AVM rupture in the literature. METHODS: Of 52 patients aged <18 years, 47 with brain AVMs (27 males and 20 females) aged 4-17 years (mean 12.2) were retrospectively reviewed. PubMed search revealed five additional studies including 267 patients where the prevalence of age-related AVMs rupture was analysed...
April 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28323878/microsurgery-for-intracranial-arteriovenous-malformation-long-term-outcomes-in-445-patients
#12
Qingqing Ren, Min He, Yunhui Zeng, Zhiyong Liu, Hao Liu, Jianguo Xu
BACKGROUND: The management of intracranial arteriovenous malformations(AVMs) poses challenges to the cerebrovascular specialists. OBJECTIVE: To review the long-term outcomes of intracranial AVMs treated with microsurgical resections. METHODS: We performed a retrospective review of 445 patients with intracranial AVMs treated in our hospital from January 1st, 2008 to December 31st, 2014. The extracted data included demographic characteristics, clinical presentations, Spetzler-Martin (SM) grades, Supplemented Spetzler-Martin (SM-Supp) Grades, treatment modalities, long-term outcomes, and obliteration rates...
2017: PloS One
https://www.readbyqxmd.com/read/28323192/multimodality-management-of-spetzler-martin-grade-3-brain-arteriovenous-malformations-with-subgroup-analysis
#13
Isaac Josh Abecassis, John D Nerva, Abdullah Feroze, Jason Barber, Basavaraj V Ghodke, Louis J Kim, Laligam N Sekhar
INTRODUCTION: Spetzler-Martin grade 3 (SM3) lesions entail 4 distinct subtypes described based on size, eloquence, and deep venous drainage (DVD) (3A-3D). The ideal management of each is contentious, and the results of A Randomized Trial of Unruptured Brain AVMs (ARUBA) introduced additional controversy and attention towards management strategies of unruptured bAVMs. METHODS: We retrospectively reviewed 114 patients with treated SM3 bAVMs, including both ruptured and unruptured lesions...
March 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28283870/-dirty-coagulation-technique-as-an-alternative-to-microclips-for-control-of-bleeding-from-deep-feeders-during-brain-arteriovenous-malformation-surgery
#14
Danil A Kozyrev, Peeraphong Thiarawat, Behnam Rezai Jahromi, Patcharin Intarakhao, Joham Choque-Velasquez, Ferzat Hijazy, Mario K Teo, Juha Hernesniemi
BACKGROUND: Meticulous haemostasis is one of the most important factors during microneurosurgical resection of brain arteriovenous malformation (AVM). Controlling major arterial feeders and draining veins with clips and bipolar coagulation are well-established techniques, while managing with bleeding from deep tiny vessels still proves to be challenging. This technical note describes a technique used by the senior author in AVM surgery for last 20 years in dealing with the issue highlighted...
May 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28132013/new-predictive-model-for-microsurgical-outcome-of-intracranial-arteriovenous-malformations-study-protocol
#15
Xianzeng Tong, Jun Wu, Yong Cao, Yuanli Zhao, Shuo Wang
INTRODUCTION: Although microsurgical resection is currently the first-line treatment modality for arteriovenous malformations (AVMs), microsurgery of these lesions is complicated due to the fact that they are very heterogeneous vascular anomalies. The Spetzler-Martin grading system and the supplementary grading system have demonstrated excellent performances in predicting the risk of AVM surgery. However, there are currently no predictive models based on multimodal MRI techniques. The purpose of this study is to propose a predictive model based on multimodal MRI techniques to assess the microsurgical risk of intracranial AVMs...
January 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28042014/microsurgical-outcome-of-unruptured-brain-arteriovenous-malformations-a-single-center-experience
#16
Xianzeng Tong, Jun Wu, Yong Cao, Yuanli Zhao, Shuo Wang, Jizong Zhao
OBJECTIVE: We describe our single-center experience treating unruptured brain arteriovenous malformations (uBAVMs) with microsurgical treatment. METHODS: During a 7-year period, 282 patients with uBAVMs were surgically treated at our institution. Patient clinical features, postsurgical complications, arteriovenous malformation obliteration rate, seizure control, and functional outcome were collected and analyzed. Seizure control was evaluated with the Engel classification system...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28009020/the-relationship-of-cortical-folding-and-brain-arteriovenous-malformations
#17
Manish N Shah, Sarah E Smith, Donna L Dierker, Joseph P Herbert, Timothy S Coalson, Brent S Bruck, Gregory J Zipfel, David C Van Essen, Ralph G Dacey
BACKGROUND: The pathogenesis of human intracranial arteriovenous malformations (AVMs) is not well understood; this study aims to quantitatively assess cortical folding in patients with these lesions. METHODS: Seven adult participants, 4 male and 3 female, with unruptured, surgically unresectable intracranial AVMs were prospectively enrolled in the study, with a mean age of 42.1 years and Spetzler-Martin grade range of II-IV. High-resolution brain MRI T1 and T2 sequences were obtained...
2016: Neurovascular Imaging (London)
https://www.readbyqxmd.com/read/27932749/-hemorrhage-from-an-angiographically-obliterated-arteriovenous-malformation-after-gamma-knife-radiosurgery-an-immunohistochemistry-study
#18
Saori Hamada, Daina Kashiwazaki, Tetsuhiro Kamo, Takahiro Tomita, Naoki Akioka, Naoya Kuwayama, Satoshi Kuroda
A 24-year-old woman was diagnosed with a cerebral arteriovenous malformation(AVM)in the right parietal lobe(Spetzler-Martin grade I). The AVM was treated with stereotactic radiosurgery and was observed to have completely disappeared 3 years after radiosurgery. At the age of 35 years, the patient complained of a headache, and was referred to our hospital. A plain CT scan demonstrated a large cyst with niveau formation in the right parietal lobe. Cerebral angiography identified no recurrence of AVM. However, contrast MRI revealed an enhanced lesion on the surface of the cyst...
December 2016: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/27911249/international-multicenter-cohort-study-of-pediatric-brain-arteriovenous-malformations-part-2-outcomes-after-stereotactic-radiosurgery
#19
MULTICENTER STUDY
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...
February 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27903925/onyx-extravasation-during-embolization-of-a-brain-arteriovenous-malformation
#20
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
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