Outcomes of arteriovenous malformations with single versus multiple draining veins: A multicenter study.
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Musmar Basel, Abdalrazeq Hammam, Adeeb Nimer, Roy Joanna M, Aslan Assala, Tjoumakaris Stavropoula I, Salim Hamza Adel, Ogilvy Christopher S, Baskaya Mustafa K, Kondziolka Douglas, Sheehan Jason, Riina Howard, Kandregula Sandeep, Dmytriw Adam A, Abushehab Abdallah, El Naamani Kareem, Abdelsalam Ahmed, Ironside Natasha, Kumbhare Deepak, Gummadi Sanjeev, Ataoglu Cagdas, Essibayi Muhammed Amir, Keles Abdullah, Muram Sandeep, Sconzo Daniel, Rezai Arwin, Alwakaa Omar, Tos Salem M, Mantziaris Georgios, Park Min S, Erginoglu Ufuk, Pöppe Johannes, Sen Rajeev D, Griessenauer Christoph J, Burkhardt Jan-Karl, Starke Robert M, Sekhar Laligam N, Levitt Michael R, Altschul David J, Haranhalli Neil, McAvoy Malia, Zeineddine Hussein A, Abla Adib A, Sizdahkhani Saman, Koduri Sravanthi, Atallah Elias, Karadimas Spyridon, Gooch M Reid, Rosenwasser Robert H, Stapleton Christopher, Koch Matthew, Srinivasan Visish M, Chen Peng R, Blackburn Spiros, Bulsara Ketan, Kim Louis J, Choudhri Omar, Pukenas Bryan, Orbach Darren, Smith Edward, Mosimann Pascal J, Alaraj Ali, Aziz-Sultan Mohammad A, Patel Aman B, Savardekar Amey, Notarianni Christina, Cuellar Hugo H, Lawton Michael, Guthikonda Bharat, Morcos Jacques, Jabbour Pascal, MISTA consortium
Аннотация
METHODS: We conducted a retrospective analysis of 735 AVM patients from the Multicenter International Study for Treatment of Brain AVMs (MISTA) database. Patients were categorized into single draining vein (n = 430) and multiple draining veins (n = 305) groups. Logistic and linear regression models were used to assess outcomes, adjusting for baseline characteristics, including age, rupture status, Spetzler-Martin grade, and other relevant factors.
RESULTS: After adjustment, no significant differences were observed in complete AVM obliteration at last follow-up between the multiple and single draining veins groups (OR: 1.1; 95 % CI: 0.72-1.93, p = 0.49) after any treatment type. Good functional outcomes at last follow-up (mRS 0-2) were similar between the two groups (OR: 1.00; 95 % CI: 0.48-2.09, p = 0.98), as were retreatment rates (OR: 1.68; 95 % CI: 0.74-3.83, p = 0.21). Ruptured AVMs were more common in the single draining vein group (52.0 % vs. 35.4 %, p < 0.001). Patients in the multiple draining vein group had lower odds of hemorrhagic complications compared to the single vein group (OR: 0.38; 95 % CI: 0.14-1.02, p = 0.05).
CONCLUSION: Single draining vein AVMs were more likely to present with rupture, but no significant differences in obliteration rates, functional outcomes, or retreatment rates were found between the groups after adjustment. These findings suggest that while venous drainage patterns may influence initial presentation, they do not appear to affect overall treatment success or patient prognosis after any treatment type. Further studies are needed to confirm.