Document Detail


Endovascular treatment accounts for a change in brain arteriovenous malformation natural history risk.
MedLine Citation:
PMID:  20642886     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study estimated the risk and rates of intracranial hemorrhage (ICH) in patients harbor-ing brain arteriovenous malformation (BAVM) after endovascular embolization. One hundred and forty-four consecutive patients with BAVM treated with endovascular embolization between 1998 and 2003 were retrospectively reviewed. The risk of ICH subsequent to endovascular embolization was studied using Kaplan-Meier curves. We reviewed 144 patients with BAVM treated with endovascular embolization. Two hundred and sixty-nine procedures were performed, 69 were performed with silk sutures, 18 with coils, 137 with NBCA and 36 with Onyx18. Twenty-three (16.0%) patients were treated with additional gamma-knife radiosurgery and one (0.7%) with additional surgical AVM excision. Complete obliteration of BAVMs was achieved in 20 patients (13.9%). During a mean follow-up of 5.9 years for the ICH group and 6.9 years for the non-ICH group, hemorrhages occurred in 11 (17.7%) of the ICH patients and in nine (11%) of the non-ICH group (p>0.1). The annual risk of hemorrhage was 3.0% and 1.6%, respectively. In the multivariate regression model, the adjusted relative risk (RR) for hemorrhage at initial presentation was 1.6 (95% CI 1.2-3.2; p>0.1). Deep venous drainage, male sex, age or AVM size were not significantly associated with subsequent hemorrhage. ICH and non-ICH groups did not differ in progression to subsequent ICH after endovascular embolization (log-rank X (2) =1.339, p>0.1) in survival analyses. The overall annual hemorrhage risk for all patients after endovascular embolization was 2.1%. Endovascular embolization alone or combined with gamma-knife radiosurgery or surgical treatment are able to decrease ICH occurrence compared to abstention.
Authors:
X Lv; Z Wu; C Jiang; Y Li; X Yang; Y Zhang; M Lv; N Zhang
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Publication Detail:
Type:  Journal Article     Date:  2010-07-19
Journal Detail:
Title:  Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences     Volume:  16     ISSN:  1591-0199     ISO Abbreviation:  Interv Neuroradiol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-07-20     Completed Date:  2010-10-07     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  9602695     Medline TA:  Interv Neuroradiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  127-32     Citation Subset:  IM    
Affiliation:
Beijing Neurosurgical Institute, Capital Medical University; Beijing, China. lvxianli000@163.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Embolization, Therapeutic / mortality*
Female
Follow-Up Studies
Humans
Intracranial Arteriovenous Malformations / mortality*,  therapy*
Intracranial Hemorrhages / mortality*
Kaplan-Meier Estimate
Male
Multivariate Analysis
Regression Analysis
Retrospective Studies
Risk Factors
Severity of Illness Index
Young Adult
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