Медицинская библиотека · European stroke journal · 2026

Predictors of complete obliteration and favourable outcome after single-modality treatment for low-grade arteriovenous malformations: a multicentre study.

Fuentes Angelica M, Tos Salem M, Ironside Natasha, Mantziaris Georgios, Shinya Yuki, Musmar Basel, Salim Hamza Adel, Adeeb Nimer, Ogilvy Christopher S, Kondziolka Douglas, Alaraj Ali, Park Min S, Dmytriw Adam A, Zeineddine Hussein, Mccarthy Finn, Abou-Al-Shaar Hussam, Abdelsalam Ahmed, Baskaya Mustafa, Ataoglu Cagdas, Sanchez-Forteza Anthony, Essibayi Muhammed Amir, Keles Abdullah, Muram Sandeep, Riina Howard, Rezai Arwin, Hanalioglu Sahin, Erginoglu Ufuk, Pöppe Johannes, Simonato Davide, Li Yan-Lin, Kandregula Sandeep, Lakhani Dhairya A, Griessenauer Christoph J, Kasem Rahim Abo, Spiotta Alejandro M, Puri Ajit S, Singh Jasmeet, Kuhn Anna Luisa, Burkhardt Jan Karl, Starke Robert M, Sekhar Laligam N, Levitt Michael R, Altschul David, Haranhalli Neil, McAvoy Malia, Foreman Paul, Zaidat Osama O, AlMajali Mohammad H, Shakir Hakeem J, See Alfred Pokmeng, Abla Adib A, Patel Aashay, Nguyen Andrew, Koch Matthew J, Srinivasan Visish M, Chen Peng Roc, Blackburn Spiros, Bulsara Ketan R, Kan Peter, Kim Louis, Choudhri Omar, Tjoumakaris Stavropoula I, Jabbour Pascal, Savardekar Amey, Cuellar Hugo H, Lawton Michael T, Guthikonda Bharat, Morcos Jacques, Sheehan Jason P, MISTA Consortium

СтатьяМногоцентровое исследованиеПеревод в очереди

Аннотация

INTRODUCTION

Patient and arteriovenous malformation (AVM) characteristics that portend success after treatment for low-grade brain AVMs remain unknown.

PATIENTS AND

METHODS

We utilised the MISTA multicentre registry to identify patients with Spetzler-Martin (SM) grade I or II AVMs treated with stand-alone curative-intent intervention (resection, stereotactic radiosurgery [SRS] or endovascular embolisation). Bivariate and multivariable analyses were performed to identify patient and AVM characteristics predictive of complete obliteration or favourable outcome (complete obliteration without new permanent deficit or post-treatment haemorrhage).

RESULTS

A total of 522 patients were included (292 microsurgery, 152 SRS, 78 embolisation). Complete obliteration rates differed between microsurgery (95.9%), SRS (75.0%) and embolisation (71.8%) (P < .001); among patients classified as cured, digital subtraction angiography (DSA) confirmed obliteration in 96.1%, 75.9% and 52.4%, respectively. Favourable outcome was achieved in 89.4%, 64.5% and 67.9% (P < .001). In adjusted models for obliteration, elderly age (odds ratio [OR] 0.49, P = .022), larger nidus (OR 0.64, P = .005) and compacted morphology (OR 1.93, P = .019) were independent predictors overall; paediatric age predicted incomplete obliteration after microsurgery (OR 0.05, P = .045), and elderly age (OR 0.19, P = .001) and larger nidus (OR 0.59, P = .015) after SRS. For favourable outcome, SM grade II overall (adjusted OR [aOR] 0.58, P = .031) and elderly age after SRS (aOR 0.31, P = .019) were independent negative predictors.

DISCUSSION: Low-grade AVMs showed high rates of complete obliteration, though DSA-confirmed rates were substantially lower after embolisation, underscoring the importance of angiographic confirmation.

CONCLUSION

The predictors identified in this study may help guide management when 2 or 3 of the primary treatment options carry clinical equipoise.

Для цитирования: Fuentes Angelica M, Tos Salem M, Ironside Natasha, Mantziaris Georgios, Shinya Yuki, Musmar Basel, Salim Hamza Adel, Adeeb Nimer, Ogilvy Christopher S, Kondziolka Douglas, Alaraj Ali, Park Min S, Dmytriw Adam A, Zeineddine Hussein, Mccarthy Finn, Abou-Al-Shaar Hussam, Abdelsalam Ahmed, Baskaya Mustafa, Ataoglu Cagdas, Sanchez-Forteza Anthony, Essibayi Muhammed Amir, Keles Abdullah, Muram Sandeep, Riina Howard, Rezai Arwin, Hanalioglu Sahin, Erginoglu Ufuk, Pöppe Johannes, Simonato Davide, Li Yan-Lin, Kandregula Sandeep, Lakhani Dhairya A, Griessenauer Christoph J, Kasem Rahim Abo, Spiotta Alejandro M, Puri Ajit S, Singh Jasmeet, Kuhn Anna Luisa, Burkhardt Jan Karl, Starke Robert M, Sekhar Laligam N, Levitt Michael R, Altschul David, Haranhalli Neil, McAvoy Malia, Foreman Paul, Zaidat Osama O, AlMajali Mohammad H, Shakir Hakeem J, See Alfred Pokmeng, Abla Adib A, Patel Aashay, Nguyen Andrew, Koch Matthew J, Srinivasan Visish M, Chen Peng Roc, Blackburn Spiros, Bulsara Ketan R, Kan Peter, Kim Louis, Choudhri Omar, Tjoumakaris Stavropoula I, Jabbour Pascal, Savardekar Amey, Cuellar Hugo H, Lawton Michael T, Guthikonda Bharat, Morcos Jacques, Sheehan Jason P, MISTA Consortium. Predictors of complete obliteration and favourable outcome after single-modality treatment for low-grade arteriovenous malformations: a multicentre study.. European stroke journal. 2026. DOI: 10.1093/esj/aakag103.

Предметные рубрики MeSH

Humans Female Treatment Outcome Intracranial Arteriovenous Malformations Embolization, Therapeutic Radiosurgery Male Adult Middle Aged Registries Microsurgery Adolescent Angiography, Digital Subtraction Young Adult Aged Child

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