• Sergio Moreno-Jiménez, Miguel Angel Celis, José Manuel Lárraga-Gutiérrez, José de Jesús Suárez-Campos, Amanda García-Garduño, and Mariana Hernández-Bojórquez.
• Neurosurgery, National Institute of Neurology and Neurosurgery, Mexico City, C.P. 14269, México DF. ser_radioneurocirugia@yahoo.com.mx <ser_radioneurocirugia@yahoo.com.mx>
• Surg Neurol. 2007 May 1; 67 (5): 487-91; discussion 491-2.

BackgroundLittle is written about the clinical outcome and predictor factors of obliteration and treatment success in patients with intracranial AVMs treated with LINAC-based conformal radiosurgery in Mexican institutions.MethodsWe analyzed 40 patients with intracranial AVMs with a mean follow-up of 29 (range, 23-34) months. Seven AVMs (17.5%) had a volume <1 cm(3); 10 (25%), 1 to 4 cm(3); 13 (32.5%), 4.1 to 10 cm(3); and 10 (25%), >10 cm(3). The mean prescription dose was 15.4 Gy. Twenty-six patients (68%) presented hemorrhage before treatment; 4 (10%), chronic headache; 14 (35%), seizures; and 3(8%), neurologic deficit.ResultsSeven patients (17.5%) underwent objective clinical improvement. Thirty patients (75%) remained without clinical changes. Three patients (7.5%) developed edema and 1 (2.5%) had a rebleeding after treatment. Twenty-five patients (63%) presented complete obliteration of the AVM. A successful treatment (obliteration without a new deficit) was obtained in 23 (58%) of the cases. The percentage of obliteration was in <1 cm(3) (86%), 1 to 4 cm(3) (80%), 4.1 to 10 cm(3) (54%), and >10 cm(3) (40%), without a significant difference between groups (P = .1). Patients with RBAS of 1.9, 48%; the successful treatment in the former resulted in 79% and, in the latter, 38% (P = .08 and P = .02, respectively).ConclusionsThe clinical outcome was similar to other series. The RBAS seems to be a good predictor of obliteration and successful treatment in patients with AVMs treated with LINAC-based conformal radiosurgery.

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