Long-term Outcomes of Patients With Giant Intracranial Arteriovenous Malformations

Yang, Wuyang; Wei, Zhikui; Wang, Joanna Y.; Hung, Alice L.; Caplan, Justin M.; Braileanu, Maria; Colby, Geoffrey P.; Coon, Alexander L.; Tamargo, Rafael J.; Huang, Judy

doi:10.1227/neu.0000000000001189

Cited by 14 publications

(10 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study suggests that interventions for giant AVMs should be considered cautiously because hemorrhagic risk is similar regardless of management strategy and functional outcome is likely to be same or better in the conservatively managed population. [38]…”

Section: Methodsmentioning

confidence: 99%

Expert consensus on the management of brain arteriovenous malformations

Kato

Dong²,

Chaddad-Neto

et al. 2019

Asian J Neurosurg

View full text Add to dashboard Cite

Brain arteriovenous malformations (bAVMs) are complex, heterogeneous, and uncommon intracranial lesions. They can be treated by one or a combination of the following treatment modalities, namely embolization, radiosurgery, or microsurgical resection. In Spetzler-Martin Grade 4 and 5 arteriovenous malformations (AVMs), conservative management may be the best option. A group of experts in the management of AVMs of different disciplines gathered in January 2019 in Hanoi to compile the "Expert Consensus on the Management of Brain Arteriovenous Malformations".

show abstract

Section: Methodsmentioning

confidence: 99%

Expert consensus on the management of brain arteriovenous malformations

Kato

Dong²,

Chaddad-Neto

et al. 2019

Asian J Neurosurg

View full text Add to dashboard Cite

show abstract

“…For example, conservative management of intracranial vascular abnormalities or surveillance after treatment may require prolonged observation and interval follow-up. [13][14][15] Similarly, chronic findings were less likely to have explicitly stated IC (P Ͻ .001). However, monitoring chronic findings for long periods may have clinical significance.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Explicitly Stated Interval Change on Noncontrast Head CT Radiology Reports

Braileanu

Crawford

Key

et al. 2019

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

BACKGROUND AND PURPOSE: Consistent and standardized reporting of interval change for certain diagnoses may improve the clinical utility of radiology reports. The purpose of this study was to assess explicitly stated interval change of various findings in noncontrast head CT reports. MATERIALS AND METHODS: A retrospective review was performed on successive noncontrast head CT radiology reports from the first 2 weeks of January 2014. Reports with at least 1 prior comparison CT scan were included. Reports with normal examination findings and those that made comparison with only other types of examinations (eg, MR imaging) were excluded. Descriptive and subgroup statistical analyses were performed. RESULTS: In total, 200 patients with 230 reports and 979 radiographic findings were identified. The average interval between reports was 344.9 Ϯ 695.9 days (range, 0-3556 days). Interval change was mentioned 67.3% (n ϭ 659) of the time for all findings (n ϭ 979). Explicitly stated interval change was significantly associated with nonremote findings (P Ͻ .001) and generalized statements of interval change (P Ͻ .001). The proportion of interval change reported ranged from 95.3% of the time for hemorrhagic to 36.4% for soft-tissue/osseous categorizations. CONCLUSIONS: Interval change reporting was variable, mentioned for 67.3% of noncontrast head CT report findings with a prior comparison CT scan. Structured radiology reports may improve the consistent and clear reporting of interval change for certain findings.

show abstract

“…The ARUBA trial did not include giant bAVMs, and it is still controversial whether the intervention can benefit giant bAVMs in other previous studies [ 2 ]. Yang et al indicated that interventions for giant bAVMs should be considered cautiously because the hemorrhagic risk is similar and functional outcomes may be better in the conservatively managed population [ 17 ]. In contrast, Chang et al proposed that selected symptomatic patients with giant bAVMs can be treated successfully with good outcomes and acceptable risk [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Contemporary management of brain arteriovenous malformations in mainland China: a web-based nationwide questionnaire survey

Chen

Meng

et al. 2020

Chin Neurosurg Jl

View full text Add to dashboard Cite

Background: In the benefit of the large population and rapid economic growth, the interventional techniques and equipment for brain arteriovenous malformations (bAVMs) in mainland China have been rapidly improved. Chinese neurosurgical cerebrovascular physicians have accumulated rich experience and made pioneering explorations. This study aims to summarize the experience and treatment progress of bAVMs in mainland China. Methods: We performed a web-based nationwide questionnaire survey among 67 tertiary neurosurgical institutions that had acknowledged treating bAVMs in the primary survey. Our questionnaire included clinical characteristics, radiological findings, intervention indications/contraindications, intervention timing, and intraoperative management of different treatment modalities. Results: A total of 63 participants from 49 (73.1%) tertiary neurosurgical institutions responded to our questionnaire. Forty-two (66.7%) were neurosurgeons, 13 (20.6%) were neurointerventionists, and 8 (12.7%) were radiosurgeons. Approximately 3500 to 4000 cases of bAVMs were treated annually in these 49 departments. All participants agreed that the conclusions of ARUBA are debatable. Flow-related aneurysms, deep venous drainage, and arteriovenous fistula were considered as common hemorrhagic risk factors. Unruptured SM IV-V bAVMs, giant bAVMs, pediatric bAVMs, elderly bAVMs, and eloquent bAVMs were not absolute contraindications to intervention. Maximum lesion occlusion and minimal functional impairment were the principles of intervention management. Most of the neurosurgeons and neurointerventionists recommended early intervention (< 30 days) for ruptured bAVMs, and the radiosurgeons suggested intervention in the chronic phase or recovery phase (P < 0.01) and preferably 3 months after bleeding. Multi-modality strategies were thought effective for complex bAVMs, and more exploration of individualized intraoperative management was necessary.

show abstract

Long-term Outcomes of Patients With Giant Intracranial Arteriovenous Malformations

Abstract: AVM, arteriovenous malformationmRS, modified Rankin Scale.

Cited by 14 publications

References 40 publications

Expert consensus on the management of brain arteriovenous malformations

Expert consensus on the management of brain arteriovenous malformations

Assessment of Explicitly Stated Interval Change on Noncontrast Head CT Radiology Reports

Contemporary management of brain arteriovenous malformations in mainland China: a web-based nationwide questionnaire survey

Contact Info

Product

Resources

About