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Talaat M, Premat K, Lenck S, et al. Exclusion treatment of ruptured and unruptured low-grade brain arteriovenous malformations: a systematic review. Neuroradiology. 2021;doi: 10.1007/s00234-021-02714-x.
Talaat, M., Premat, K., Lenck, S., Shotar, E., Boch, A. L., Bessar, A., Taema, M., Hassan, F., Elserafy, T. S., Degos, V., Sourour, N., & Clarençon, F. (2021). Exclusion treatment of ruptured and unruptured low-grade brain arteriovenous malformations: a systematic review. Neuroradiology, . https://doi.org/10.1007/s00234-021-02714-x
Talaat, Maichael, et al. "Exclusion treatment of ruptured and unruptured low-grade brain arteriovenous malformations: a systematic review." Neuroradiology vol. (2021). doi: https://doi.org/10.1007/s00234-021-02714-x
Talaat M, Premat K, Lenck S, Shotar E, Boch AL, Bessar A, Taema M, Hassan F, Elserafy TS, Degos V, Sourour N, Clarençon F. Exclusion treatment of ruptured and unruptured low-grade brain arteriovenous malformations: a systematic review. Neuroradiology. 2021 Sep 25; doi: 10.1007/s00234-021-02714-x. Epub 2021 Sep 25. PMID: 34562139.
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Neuroradiology. 2021 Sep 25; doi: 10.1007/s00234-021-02714-x. Epub 2021 Sep 25.

Exclusion treatment of ruptured and unruptured low-grade brain arteriovenous malformations: a systematic review.

Neuroradiology

Maichael Talaat, Kévin Premat, Stéphanie Lenck, Eimad Shotar, Anne-Laure Boch, Awad Bessar, Mohammed Taema, Farouk Hassan, Tamer S Elserafy, Vincent Degos, Nader Sourour, Frédéric Clarençon

Affiliations

  1. Department of Interventional Neuroradiology, GRC BioFast, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospital, 75013, Paris, France.
  2. Department of Radiodiagnosis, Faculty of Medicine, Zagazig University E44519, Zagazig, Egypt.
  3. Department of Interventional Neuroradiology, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospital, 47-83 Boulevard de l'Hôpital 75013, Paris, France.
  4. Department of Neurosurgery, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospital, 75013, Paris, France.
  5. Department of Radiodiagnosis, Faculty of Medicine, Cairo University, Cairo, C12613, Egypt.
  6. Department of Neurology, Faculty of Medicine, Zagazig University, Zagazig, E44519, Egypt.
  7. Department of Anesthesiology and Critical Care, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospital, 75013, Paris, France.
  8. Department of Interventional Neuroradiology, GRC BioFast, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospital, 75013, Paris, France. [email protected].
  9. Department of Interventional Neuroradiology, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospital, 47-83 Boulevard de l'Hôpital 75013, Paris, France. [email protected].

PMID: 34562139 DOI: 10.1007/s00234-021-02714-x

Abstract

PURPOSE: To assess the obliteration rate, functional outcome, hemorrhagic complication, and mortality rates of exclusion treatment of low-grade brain arteriovenous malformations (BAVMs) (Spetzler and Martin grades (SMGs) 1 and 2), either ruptured or unruptured.

METHODS: Electronic databases-Ovid MEDLINE and PubMed-were searched for studies in which there was evidence of exclusion treatment of low-grade BAVMs treated either by endovascular, surgical, radiosurgical, or multimodality treatment. The primary outcome of interest was angiographic obliteration post-treatment and at follow-up. The secondary outcomes of interest were functional outcome (mRS), mortality rate, and hemorrhagic complication. Descriptive statistics were used to calculate rates and means.

RESULTS: Eleven studies involving 1809 patients with low-grade BAVMs were included. Among these, 1790 patients treated by either endovascular, surgical, radiosurgical, or multimodality treatment were included in this analysis. Seventy-two percent of BAVMs were Spetzler-Martin grade II. The overall (i.e., including all exclusion treatment modalities) complete obliteration rate ranged from 36.5 to 100%. The overall symptomatic hemorrhagic complication rate ranged from 0 to 7.3%; procedure-related mortality ranged from 0 to 4.7%.

CONCLUSION: Our systematic review of the literature reveals a high overall obliteration rate for low-grade BAVMs, either ruptured or unruptured, with low mortality rate and an acceptable post-treatment hemorrhagic complication rate. These results suggest that exclusion treatment of low-grade BAVMs may be safe and effective, regardless of the treatment modality chosen.

© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Keywords: Brain arteriovenous malformation; Embolization; Hemorrhage; Radiosurgery; Surgery; Vascular disorders

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