Document Detail


Radiosurgery with a linear accelerator in cerebral arteriovenous malformations.
MedLine Citation:
PMID:  18506329     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate results achieved with radiosurgery and complications of the procedure when treating arteriovenous malformations with linear accelerator. METHODS: This retrospective study was conducted between October 1993 and December 1996. Sixty-one patients with arteriovenous malformations were treated with radiosurgery utilizing a 6MV energy linear accelerator. Ages of the 32 female and 29 male patients ranged from 6 to 54 years (mean: 28.3 years). The most frequent initial symptom was cephalea (45.9%), followed by neurological deficit (36.1%). Cerebral hemorrhage diagnosed by image was observed in 35 patients (57.3%). Most arteriovenous malformations (67.2%) were graded Spetzler III and IV. Venous stenosis (21.3%) and aneurysm (13.1%) were the most frequent angioarchitecture changes. The dose administered varied from 12 to 27.5Gy in the periphery of the lesion. RESULTS: Out of twenty-eight patients that underwent conclusive angiography control, complete obliteration was achieved in 18 (72%) and treatment failed in 7 (absence of occlusion with more than 3 years of follow-up). Four were submitted to a second radiosurgery, and one of these has shown obliteration after 18 months of follow-up. DISCUSSION: Several factors were analyzed regarding the occlusion rate (gender, age, volume, localization, Spetzler, flow, embolization, total of isocenters, prescribed dose and chosen isodose) and complications (total of isocenters, localization, volume, maximum dose, prescribed dose and chosen isodose). Analyzed variables showed no statistical significance for obliteration of the vessel, as well as for treatment complications. The largest diameter of the arteriovenous malformation, its volume and the dose administered did not influence time of obliteration. CONCLUSION: Radiosurgery is effective in the treatment of arteriovenous malformations and can be an alternative for patients with clinical contraindication or with lesions in eloquent areas. In the studied variables no statistically significant correlation was observed between occlusion and treatment complications.
Authors:
Sérgio Carlos Barros Esteves; Wladimir Nadalin; Ronie Leo Piske; Salomon Benabou; Evandro de Souza; Antonio Carlos Zuliani de Oliveira
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Revista da Associação Médica Brasileira (1992)     Volume:  54     ISSN:  0104-4230     ISO Abbreviation:  Rev Assoc Med Bras     Publication Date:    2008 Mar-Apr
Date Detail:
Created Date:  2008-05-28     Completed Date:  2009-04-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9308586     Medline TA:  Rev Assoc Med Bras     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  167-72     Citation Subset:  IM    
Affiliation:
Hospital Beneficência Portuguesa de São Paulo, São Paulo, SP. estevesrt@uol.com.br
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cerebral Hemorrhage / diagnosis
Child
Dose-Response Relationship, Radiation
Epidemiologic Methods
Female
Humans
Intracranial Arteriovenous Malformations / surgery*
Magnetic Resonance Angiography
Male
Middle Aged
Particle Accelerators*
Radiosurgery / adverse effects,  methods*,  mortality
Treatment Outcome
Young Adult
Comments/Corrections
Erratum In:
Rev Assoc Med Bras. 2008 May-Jun;54(3):282

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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