Ismail Kaya1, Volkan Çakır2, Ilker Deniz Cingoz1, Murat Atar3, Gokhan Gurkan4, Meryem Cansu Sahin5, Suna Karadeniz Saygili6, Nurullah Yuceer4. 1. Medical Faculty, Department of Neurosurgery, Usak University, Usak, Turkey. 2. Medical Faculty, Department of Interventional Radiology, Tınaztepe University, Izmir, Turkey. 3. Department of Neurosurgery, Sultan 2.Abdulhamid Han Sample Training And Research Hospital, Istanbul, Turkey. 4. Medical Faculty, Department of Neurosurgery, Katip Çelebi University, Izmir, Turkey. 5. Training and Research Center, Kutahya Health Sciences University, Kutahya, Turkey. 6. Medical Faculty, Department of Histology and Embryology, Kutahya Health Sciences University, Kutahya, Turkey.
Abstract
AIM: Brain arteriovenous malformations (AVMs) are congenital anomalies that present as intracranial hemorrhage or epilepsy. AVMs often remain clinically silent for extended periods. Although AVM treatment methods are controversial, three treatment strategies are usually combined or applied alone: surgical removal, embolization and stereotactic radiosurgery. We compared clinical and radiological outcomes in intracranial AVM patients treated via surgical resection with and without prior embolization. MATERIALS AND METHODS: Patients who did (30 patients) and did not (30 patients) undergo endovascular embolization before surgical resection at the İzmir Katip Çelebi University Atatürk Training and Research Hospital Neurosurgery Clinic from 2011 to 2019 were included in this retrospective, cohort study. Symptoms at diagnosis, comorbidities and clinical (AVM and Spetzler-Martin grade) and morphological characteristics were assessed. RESULTS: A mean one-year follow-up assessed outcomes using the modified Rankin score, and imaging studies assessed AVM obliteration post-procedure. Mean operation times for surgical resection with and without embolization were 166.50 ± 32.02 and 204.47 ± 26.66 min, respectively. Mean patient hospitalization periods for surgical resection with and without embolization were 8.43 ± 3.60 and 12.00 ± 5.51 days, respectively. CONCLUSION: Among patients who underwent surgical resection, significant operation time and hospitalization time differences were observed in favor of patients who underwent embolization, indicating that preoperative embolization is a safe and beneficial method for treating ruptured and non-ruptured AVMs.
AIM: Brain arteriovenous malformations (AVMs) are congenital anomalies that present as intracranial hemorrhage or epilepsy. AVMs often remain clinically silent for extended periods. Although AVM treatment methods are controversial, three treatment strategies are usually combined or applied alone: surgical removal, embolization and stereotactic radiosurgery. We compared clinical and radiological outcomes in intracranial AVM patients treated via surgical resection with and without prior embolization. MATERIALS AND METHODS: Patients who did (30 patients) and did not (30 patients) undergo endovascular embolization before surgical resection at the İzmir Katip Çelebi University Atatürk Training and Research Hospital Neurosurgery Clinic from 2011 to 2019 were included in this retrospective, cohort study. Symptoms at diagnosis, comorbidities and clinical (AVM and Spetzler-Martin grade) and morphological characteristics were assessed. RESULTS: A mean one-year follow-up assessed outcomes using the modified Rankin score, and imaging studies assessed AVM obliteration post-procedure. Mean operation times for surgical resection with and without embolization were 166.50 ± 32.02 and 204.47 ± 26.66 min, respectively. Mean patient hospitalization periods for surgical resection with and without embolization were 8.43 ± 3.60 and 12.00 ± 5.51 days, respectively. CONCLUSION: Among patients who underwent surgical resection, significant operation time and hospitalization time differences were observed in favor of patients who underwent embolization, indicating that preoperative embolization is a safe and beneficial method for treating ruptured and non-ruptured AVMs.
Authors: Marian T Park; Muhammed Amir Essibayi; Visish M Srinivasan; Joshua S Catapano; Christopher S Graffeo; Michael T Lawton Journal: Neurosurg Rev Date: 2022-09-27 Impact factor: 2.800
Authors: Brent C Morel; Blake Wittenberg; Jessa E Hoffman; David E Case; Zach Folzenlogen; Christopher Roark; Joshua Seinfeld Journal: J Pers Med Date: 2022-05-30