Multimodal treatments of brain arteriovenous malformations: a comparison of microsurgical timings after endovascular embolization
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Le résumé fourni par la source
Background: To compare the clinical outcomes of hybrid microsurgery and embolization with multistaged procedure for patients harboring brain arteriovenous malformations (bAVMs).Methods: We retrospectively reviewed bAVM patients from a multicenter, prospectively collected database (NCT03774017) between June 2016 and June 2020.Patients were divided into single-staged hybrid operation (HO) group and multi-staged operation (MO) group according to the received treatment, in which microsurgeries were performed with embolization in a single setting or with multi-stage procedure, respectively.Cases were 1:1 matched between the two groups.Outcomes were compared between groups, which included neurological deficits (NDs), perioperative rupture, and proportion of complete resection.Variables associated with NDs were analyzed.Results: In total, 198 out of 544 cases were identified, including 120 in the HO group and 78 in the MO group.Sixty-six cases were matched in each group resulting in a total of 132 patients in this case-controlled study.Mean age was 29.2 years old, with 82 (62.1%) being male.No significant difference was observed in baseline demographics and clinical characteristics between the two groups.There were 7 ruptures occurred in the interval between embolization and microsurgery for MO group while none in the HO group (P=0.023).This yielded a rupture risk of 4.1% per year for the MO group.Duration of surgical resection was significantly reduced in HO group (P=0.001).Compared to MO, HO was more favorable to avoid shortterm NDs (3.0% vs. 15.2%,P=0.021), but long-term outcomes were similar.The HO modality (OR, 0.110; 95% CI: 0.017-0.737;P=0.023) was confirmed as the protective factor for short-term NDs.Conclusions: HO is an effective setup to treat complex bAVMs with avoiding interval hemorrhage risk and reducing surgical risk.We also observed overall similar obliteration rate and resulting clinical outcomes between HO and MO.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Multimodal treatments of brain arteriovenous malformations: a comparison of microsurgical timings after endovascular embolization
- Date Crossref
- 01/07/2022
- Éditeur
- AME Publishing Company
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Capital Medical University Department of Neurosurgery pays non établi dans la noticeUniversité ou école supérieure
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Beijing Tian Tan Hospital pays non établi dans la noticeÉtablissement de santé
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Johns Hopkins University Department of Neurosurgery pays non établi dans la noticeUniversité ou école supérieure
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Johns Hopkins Medicine pays non établi dans la noticeÉtablissement de santé
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National Clinical Research Center for Digestive Diseases pays non établi dans la noticeÉtablissement de santé
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Beijing Institute of Neurosurgery pays non établi dans la noticeStructure de recherche
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Chinese Institute for Brain Research pays non établi dans la noticeOrganisme public
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Beijing Institute for Brain Disorders Center of Stroke pays non établi dans la noticeStructure de recherche
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Chinese Academy of Sciences Savaid Medical School pays non établi dans la noticeOrganisme public
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China Academy of Chinese Medical Sciences pays non établi dans la noticeUniversité ou école supérieure
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Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease pays non établi dans la noticeStructure de recherche
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China National Clinical Research Center for Neurological Diseases pays non établi dans la noticeStructure de recherche
Department of Neurosurgery — Capital Medical University, Beijing Tian Tan Hospital et Department of Neurosurgery — Johns Hopkins University, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.