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Multiple brain arteriovenous malformations: systematic review and individual patient data meta-analysis
Juan E Basilio-Flores1, Joel A Aguilar-Melgar1, Cynthia B Zevallos2
1School of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru.
Neurosurgical Review
|January 28, 2023
Summary
Multiple brain arteriovenous malformations (bAVM) are rare. Angiographically occult untreated bAVM predicts instability after staged treatment. Deep or eloquent locations predict residual disease post-treatment.
Area of Science:
- Neuroscience
- Vascular Neurology
- Genetics
Background:
- Multiple brain arteriovenous malformations (bAVM) are rare, often linked to genetic syndromes, with management challenges due to their rarity.
- Understanding clinical and angiographic features is crucial for optimizing treatment outcomes in patients with multiple bAVMs.
Approach:
- A systematic literature review and single-center registry analysis identified 124 patients with 339 bAVM nidi.
- Meta-analyses of proportions and logistic regression models explored associations between patient characteristics and treatment outcomes.
Key Points:
- Angiographically occult untreated bAVM was significantly associated with nidal instability following staged treatment (OR 14.37).
- Deep (OR 5.11) and eloquent (OR 3.91) bAVM locations were associated with residual disease after treatment.
- Differences were observed between syndromic and non-syndromic cases, though data inconsistencies impacted analyses.
Conclusions:
- Specific factors like occult untreated status and lesion location influence treatment outcomes in multiple bAVM.
- Further research with consistent data reporting is needed to refine prognostic models for multiple bAVM management.
