2023 article

Third Stereotactic Radiosurgery for Residual Arteriovenous Malformations: A Retrospective Multicenter Study

Stylianos Pikis, Georgios Mantziaris, Chloé Dumot, Ahmed Taha Elsayed Shaaban, Maria Protopapa, Zhiyuan Xu, Ajay Niranjan, Zhishuo Wei, Priyanka N. Srinivasan, Lilly W. Tang, Roman Liščák, Jaromír May, Nuria Martínez Moreno, Roberto Martínez Álvarez, Selçuk Peker, Yavuz Samanci, Ahmed M. Nabeel, Wael Abdel Halim Reda, Sameh R. Tawadros, Khaled Abdelkarim, Amr M. N. El-Shehaby, Reem M. Emad, Ahmed Hesham Elazzazi, Varun Padmanaban, Francis J. Jareczek, James Oscar McInerney, Kevin M. Cockroft, Dade L. Lunsford, Jason P. Sheehan

4Citations signalées, ce qui n’est pas une note de qualité

12Institutions déclarées

6Pays d’affiliation déclarés

Rattachement africain : us, fr, cz, es, tr, Égypte. Niveau de preuve : code pays fourni par la source.

Le résumé fourni par la source

BACKGROUND AND OBJECTIVES: There are no studies evaluating the efficacy and safety of more than 2 stereotactic radiosurgery (SRS) procedures for cerebral arteriovenous malformations (AVM). The aim of this study was to provide evidence on the role of third single-session SRS for AVM residual. METHODS: This multicenter, retrospective study included patients managed with a third single-session SRS procedure for an AVM residual. The primary study outcome was defined as AVM nidus obliteration without AVM bleeding or symptomatic radiation-induced changes (RIC). Secondary outcomes evaluated were AVM obliteration, AVM hemorrhage, asymptomatic, and symptomatic RIC. RESULTS: Thirty-eight patients (20/38 [52.6%] females, median age at third SRS 34.5 [IQR 20] years) were included. The median clinical follow-up was 46 (IQR 14.8) months, and 17/38 (44.7%) patients achieved favorable outcome. The 3-year and 5-year cumulative probability rates of favorable outcome were 23% (95% CI = 10%-38%) and 53% (95% CI = 29%-73%), respectively. The cumulative probability of AVM obliteration at 3 and 5 years after the third SRS was 23% (95% CI = 10%-37%) and 54% (95% CI = 29%-74%), respectively. AVM bleeding occurred in 2 patients, and 1 of them underwent subsequent resection. The cumulative probability rate of post-SRS AVM hemorrhage remained constant at 5.3% (95% CI = 1%-16%) during the first 5 years of follow-up. Transient symptomatic RIC managed conservatively occurred in 5/38 patients (13.2%) at a median time of 12.5 (IQR 22.5) months from third SRS. Radiation-induced cyst formation was noted in 1 patient (4.2%) 19 months post-SRS. No mortality, radiation-associated malignancy, or permanent symptomatic RIC was noted during follow-up. CONCLUSION: A third single-session SRS to treat a residual intracranial AVM offers obliteration in most patients. The risk of RIC was low, and these effects were transient. While not often required, a third SRS can be performed in patients with persistent residual AVMs.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.

Le contrôle bibliographique ouvert

DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.

Titre Crossref: Third Stereotactic Radiosurgery for Residual Arteriovenous Malformations: A Retrospective Multicenter Study
Date Crossref: 18/12/2023
Éditeur: Ovid Technologies (Wolters Kluwer Health)
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

University of Virginia Health System Department of Neurological Surgery pays non établi dans la notice
Établissement de santé
Neurological Surgery pays non établi dans la notice
Établissement de santé
Hospices Civils de Lyon pays non établi dans la notice
Établissement de santé
University of Pittsburgh Department of Neurological Surgery pays non établi dans la notice
Université ou école supérieure
Na Homolce Hospital Department of Stereotactic and Radiation Neurosurgery pays non établi dans la notice
Établissement de santé
Hospital Ruber Internacional Radiosurgery Unit pays non établi dans la notice
Établissement de santé
Koç University Department of Neurosurgery pays non établi dans la notice
Université ou école supérieure
Benha University Neurosurgery Department Benha University, Égypte (code pays fourni par la source)
Université ou école supérieure
Nasser Institute hospital Gamma Knife Center Cairo Gamma Knife Center Cairo, Égypte (code pays fourni par la source)
Établissement de santé
Ain Shams University Neurosurgery Department and Clinical Oncology Department Cairo, Égypte (code pays fourni par la source)
Université ou école supérieure
Cairo University National Cancer Institute Cairo University, Égypte (code pays fourni par la source)
Université ou école supérieure
Penn State Milton S. Hershey Medical Center Department of Neurosurgery pays non établi dans la notice
Établissement de santé

Department of Neurological Surgery — University of Virginia Health System, Neurological Surgery et Hospices Civils de Lyon, avec 9 autres affiliations. Pays d’affiliation : Égypte.

Une affiliation ne permet pas de déduire la nationalité d’un auteur.

Les sujets associés

Vascular Malformations Diagnosis and TreatmentMeningioma and schwannoma managementIntracranial Aneurysms: Treatment and Complications

Consulter la publication primaire Ouvrir le DOI