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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
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Third Stereotactic Radiosurgery for Residual Arteriovenous Malformations: A Retrospective Multicenter Study
Stylianos Pikis1,2, Georgios Mantziaris1, Chloe Dumot1,3
1Department of Neurological Surgery, University of Virginia Health System, Charlottesville , Virginia , USA.
Neurosurgery
|December 18, 2023
Summary
A third stereotactic radiosurgery (SRS) procedure for residual cerebral arteriovenous malformations (AVMs) can achieve obliteration with a low risk of transient radiation-induced changes. This treatment is a viable option for persistent AVMs.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Vascular Neurology
Background:
- Limited evidence exists on the efficacy and safety of more than two stereotactic radiosurgery (SRS) procedures for cerebral arteriovenous malformations (AVMs).
- Evaluating the role of a third SRS session for AVM residuals is crucial for treatment planning.
Purpose of the Study:
- To assess the efficacy and safety of a third single-session SRS for treating residual AVMs.
- To provide evidence on AVM obliteration rates and the incidence of radiation-induced changes after a third SRS.
Main Methods:
- A multicenter, retrospective study was conducted.
- Included patients received a third single-session SRS for AVM residual.
- Primary outcome: AVM obliteration without bleeding or symptomatic radiation-induced changes (RIC).
Main Results:
- Forty-four percent of patients achieved a favorable outcome at a median follow-up of 46 months.
- The 5-year cumulative probability of AVM obliteration was 54%.
- Low rates of AVM bleeding (5.3%) and transient symptomatic RIC (13.2%) were observed.
Conclusions:
- A third single-session SRS is effective in achieving AVM obliteration for residual lesions.
- The risk of radiation-induced changes is low and effects are generally transient.
- Third SRS is a feasible option for patients with persistent residual AVMs.
