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Updated: Mar 12, 2026
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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
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Interventional therapy for brain arteriovenous malformations before and after ARUBA
Eric S Sussman1, Aditya K Iyer1, Mario Teo1
1Department of Neurosurgery, Stanford University School of Medicine Stanford, CA, USA.
Summary
The ARUBA trial
Area of Science:
- Neurosurgery
- Neurology
- Interventional Radiology
Background:
- The ARUBA trial (2014) suggested medical management alone is superior for unruptured brain arteriovenous malformations (bAVMs).
- This finding generated significant debate among healthcare professionals regarding treatment strategies for bAVMs.
Purpose of the Study:
- To assess the influence of the ARUBA trial on bAVM treatment patterns at a major tertiary care center.
- To evaluate changes in referral volume, bAVM types, and intervention methods post-ARUBA.
Main Methods:
- Retrospective review of a prospectively maintained database.
- Analysis of bAVM cases treated at Stanford Health Care and Stanford Children's Health from January 2012 to July 2015.
Main Results:
- No significant change in the overall volume of treated bAVMs was observed before and after the ARUBA trial.
- The proportion of unruptured bAVMs treated remained stable.
- Observed variations in intervention types correlated with Spetzler-Martin (SM) grades, not a shift in treatment strategy.
Conclusions:
- The ARUBA trial did not substantially alter bAVM treatment volume or the approach to unruptured cases at this institution.
- Treatment variations appear linked to AVM complexity (SM grade) rather than a direct response to ARUBA findings.
- Further research is needed to fully understand ARUBA's impact on bAVM treatment practices.
