• World Neurosurg · Apr 2022

    Predictive Factors for AVM Obliteration after Stereotactic Radiosurgery: A Single Center Study.

    • Nicholas Erickson, James Mooney, Arsalaan Salehani, Evan Thomas, Adeel Ilyas, Sage Rahm, Pedram Maleknia, Omer Yousuf, John Fiveash, Chris Dobelbower, and Winfield S Fisher.
    • Department of Neurosurgery, University of Alabama at Birmingham, Alabama, USA. Electronic address: nicholaserickson@uabmc.edu.
    • World Neurosurg. 2022 Apr 1; 160: e529-e536.

    BackgroundStereotactic radiosurgery (SRS) is particularly useful for treatment of deep arteriovenous malformations (AVMs) in eloquent territory with a high associated surgical risk. Prior studies have demonstrated high rates of AVM obliteration with SRS (60%-80%) in a latency period of 2-4 years for complete obliteration. Studies have identified several factors associated with successful obliteration of the AVM nidus; however, these present inconsistent and conflicting data. The aim of this single-center study was to examine factors associated with successful obliteration of AVMs treated with SRS.MethodsA retrospective review was performed of 210 consecutive patients undergoing SRS for brain AVMs between 2010 and 2019. The χ2 test and logistic regression analysis were used to identify patient and AVM factors associated with successful obliteration.ResultsYounger age (P = 0.034) and prior embolization (P = 0.012) were associated with complete obliteration. The presence of coronary artery disease was associated with incomplete obliteration (P = 0.04). No AVM characteristics were statistically associated with complete obliteration, although superficial venous drainage (P = 0.08) and frontal location (P = 0.06) trended toward significance.ConclusionsSuccessful obliteration of the AVM nidus was significantly associated with younger age and prior embolization. The presence of coronary artery disease negatively affected obliteration rates. These results add to the mixed results seen in the literature and emphasize the need for continued studies to delineate more specific patient and AVM factors that contribute to successful obliteration.Copyright © 2022 Elsevier Inc. All rights reserved.

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