Risk of endovascular treatment of brain arteriovenous malformations.
Publication/Presentation Date
7-1-2002
Abstract
BACKGROUND AND PURPOSE: Independently assessed data on frequency, severity, and determinants of neurological deficits after endovascular treatment of brain arteriovenous malformations (AVMs) are scarce.
METHODS: From the prospective Columbia AVM Study Project, 233 consecutive patients with brain AVM receiving > or =1 endovascular treatments were analyzed. Neurological impairment was assessed by a neurologist using the Rankin Scale before and after completed endovascular therapy. Multivariate logistic regression models were used to identify demographic, clinical, and morphological predictors of treatment-related neurological deficits. The analysis included the components used in the Spetzler-Martin risk score for AVM surgery (AVM size, venous drainage pattern, and eloquence of AVM location).
RESULTS: The 233 patients were treated with 545 endovascular procedures. Mean follow-up time was 9.6 months (SD, 18.1 months). Two hundred patients (86%) experienced no change in neurological status after treatment, and 33 patients (14%) showed treatment-related neurological deficits. Of the latter, 5 (2%) had persistent disabling deficits (Rankin score >2), and 2 (1%) died. Increasing patient age [odds ratio (OR), 1.04; 95% confidence interval (CI), 1.01 to 1.08], number of embolizations (OR, 1.41; 95% CI, 1.16 to 1.70), and absence of a pretreatment neurological deficit (OR, 4.55; 95% CI, 1.03 to 20.0) were associated with new neurological deficits. None of the morphological AVM characteristics tested predicted treatment complications.
CONCLUSIONS: From independent neurological assessment and prospective data collection, our findings suggest a low rate of disabling treatment complications in this center for endovascular brain AVM treatment. Risk predictors for endovascular treatment differ from those for AVM surgery.
Volume
33
Issue
7
First Page
1816
Last Page
1820
ISSN
1524-4628
Published In/Presented At
Hartmann, A., Pile-Spellman, J., Stapf, C., Sciacca, R. R., Faulstich, A., Mohr, J. P., Schumacher, H. C., & Mast, H. (2002). Risk of endovascular treatment of brain arteriovenous malformations. Stroke, 33(7), 1816–1820. https://doi.org/10.1161/01.str.0000020123.80940.b2
Disciplines
Medicine and Health Sciences
PubMedID
12105359
Department(s)
Department of Medicine
Document Type
Article