Sophia F Shakur1, Denise Brunozzi1, Rahim Ismail1, Dilip Pandey2, Fady T Charbel1, Ali Alaraj3. 1. Department of Neurosurgery, University of Illinois, Chicago, Illinois, USA. 2. Department of Neurology, University of Illinois, Chicago, Illinois, USA. 3. Department of Neurosurgery, University of Illinois, Chicago, Illinois, USA. Electronic address: alaraj@uic.edu.
Abstract
OBJECTIVE: The pathogenesis of venous intimal hyperplasia and venous outflow stenosis associated with cerebral arteriovenous malformation (AVM) draining veins is poorly understood. We sought to determine the relationship between venous stenosis and age. METHODS: All patients with an AVM seen at our institution between 1990 and 2016 who underwent a diagnostic cerebral angiogram were retrospectively reviewed. Draining vein stenosis was measured from angiograms before any treatment. The relationship between venous stenosis and age was assessed. RESULTS: We included 281 patients (mean age 39 years, age range 3-83 years, 55% male). Venous stenosis measuring ≥50% was present in 59 patients (21% of cohort). Peak age at presentation was 25-29 years, whereas peak frequency of venous stenosis ≥50% was 50-54 years. Venous stenosis was present in a significantly higher proportion of patients ≥50 years versus <50 years (P = 0.03). Mean percentage stenosis was significantly higher in patients ≥50 years versus <50 years (32% vs. 22%, P = 0.001). CONCLUSIONS: Clinically significant cerebral AVM draining vein stenosis appears to be associated with older age, suggesting that venous stenosis is a progressive disease that occurs by the same process that leads to intimal hyperplasia. These results should be confirmed with a population-based longitudinal study.
OBJECTIVE: The pathogenesis of venous intimal hyperplasia and venous outflow stenosis associated with cerebral arteriovenous malformation (AVM) draining veins is poorly understood. We sought to determine the relationship between venous stenosis and age. METHODS: All patients with an AVM seen at our institution between 1990 and 2016 who underwent a diagnostic cerebral angiogram were retrospectively reviewed. Draining vein stenosis was measured from angiograms before any treatment. The relationship between venous stenosis and age was assessed. RESULTS: We included 281 patients (mean age 39 years, age range 3-83 years, 55% male). Venous stenosis measuring ≥50% was present in 59 patients (21% of cohort). Peak age at presentation was 25-29 years, whereas peak frequency of venous stenosis ≥50% was 50-54 years. Venous stenosis was present in a significantly higher proportion of patients ≥50 years versus <50 years (P = 0.03). Mean percentage stenosis was significantly higher in patients ≥50 years versus <50 years (32% vs. 22%, P = 0.001). CONCLUSIONS: Clinically significant cerebral AVM draining vein stenosis appears to be associated with older age, suggesting that venous stenosis is a progressive disease that occurs by the same process that leads to intimal hyperplasia. These results should be confirmed with a population-based longitudinal study.
Authors: Murad Alqadi; Denise Brunozzi; Andreas Linninger; Sepideh Amin-Hanjani; Fady T Charbel; Ali Alaraj Journal: Med Hypotheses Date: 2019-01-07 Impact factor: 1.538