Microsurgical approach for symptomatic brain AVMs - single center experience

Area of Science:

• Neurosurgery
• Vascular Neurology
• Radiology

Background:

• Brain arteriovenous malformations (AVMs) are complex vascular lesions lacking capillaries.
• Management of AVMs presents a significant clinical challenge.
• Optimal treatment requires consideration of individual AVM characteristics.

Purpose of the Study:

• To evaluate the outcomes of surgical treatment for brain arteriovenous malformations (AVMs).
• To identify factors associated with good functional outcomes after AVM surgery.

Main Methods:

• Retrospective review of 91 patients with AVMs treated between 2001 and 2019.
• Inclusion criteria: surgical intervention and availability of pre- and post-operative angiographic studies.
• Assessment of Spetzler-Martin (SM) grade, rupture status, and AVM location.

Main Results:

• Complete microsurgical resection was achieved in 90.1% of cases.
• Good functional outcomes (mRS scale) were associated with unruptured AVMs (87.9%), low-grade AVMs (86%), and cortical location (79.5%).
• Ruptured AVMs, high-grade AVMs, and deep AVMs had significantly lower rates of good outcomes.

Conclusions:

• Microsurgical resection is a curative option for brain AVMs.
• Favorable functional outcomes are achievable with careful patient and AVM selection.
• Factors like unruptured status, low Spetzler-Martin grade, and cortical location predict better surgical results.