Outcomes of arteriovenous malformation patients with multiple versus single feeders: A multicenter retrospective study with propensity-score matching.
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Musmar Basel, Adeeb Nimer, Abdalrazeq Hammam, Roy Joanna M, Tjoumakaris Stavropoula I, Salim Hamza Adel, Kondziolka Douglas, Sheehan Jason, Ogilvy Christopher S, Riina Howard, Kandregula Sandeep, Dmytriw Adam A, El Naamani Kareem, Abdelsalam Ahmed, Ironside Natasha, Kumbhare Deepak, Ataoglu Cagdas, Essibayi Muhammed Amir, Keles Abdullah, Muram Sandeep, Sconzo Daniel, Rezai Arwin, Alwakaa Omar, Tos Salem M, Erginoglu Ufuk, Pöppe Johannes, Sen Rajeev D, Griessenauer Christoph J, Burkhardt Jan-Karl, Starke Robert M, Baskaya Mustafa K, Sekhar Laligam N, Levitt Michael R, Altschul David J, McAvoy Malia, Aslan Assala, Abushehab Abdallah, Swaid Christian, 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, Cochran Joseph, Choudhri Omar, Pukenas Bryan, Orbach Darren, Smith Edward, Mosimann Pascal J, Alaraj Ali, Aziz-Sultan Mohammad A, Patel Aman B, Cuellar Hugo H, Lawton Michael, Guthikonda Bharat, Morcos Jacques, Jabbour Pascal
Аннотация
PATIENTS AND METHODS: Data from the Multicenter International Study for Treatment of Brain AVMs (MISTA) consortium were analyzed. Propensity score matching (PSM) was used to balance cohorts. Subgroup analysis was conducted for ruptured and unruptured AVMs and different treatment options, and multivariable logistic regression was applied to assess the impact of feeding artery origin.
RESULTS: Among 953 patients, 661(69.4%) had multiple feeding arteries, and 292 (30.6%) had a single feeding artery. After PSM, which included 422 matched patients (211 in each group), the differences in obliteration rates (68.7% vs 74.8%, OR 0.73, 95% CI: 0.48-1.12, p = 0.16) and symptomatic complications (15.6% vs 11.8%, OR 1.37, 95% CI: 0.78-2.41, p = 0.25) were not significant. Subgroup analysis comparing ruptured and unruptured AVMs and different treatment options showed no significant differences across all subgroups. Multivariable analysis identified PICA feeders as significantly associated with increased odds of all complications (OR 7.33, 95% CI: 2.14-25.1, p = 0.002).
DISCUSSION AND CONCLUSION: AVMs with a single feeding artery were more likely to present with rupture, but no significant differences in obliteration rates or complications were observed between the groups after PSM. These findings suggest that while the number of feeding arteries may influence the initial presentation, it does not appear to impact overall treatment success or patient prognosis. Further prospective studies are needed to confirm these findings.