Embolization Followed by Radiosurgery for the Treatment of Brain Arteriovenous Malformations (AVMs)

医学 放射外科 栓塞 动静脉畸形 放射科 颅内动静脉畸形 四分位间距 回顾性队列研究 血管造影 外科 改良兰金量表 脑血管造影 放射治疗 内科学 缺血 缺血性中风
作者
Michael P. Marks,Mary L. Marcellus,Justin Santarelli,Robert Dodd,Huy M.,Steven D. Chang,John R. Adler,Michael Mlynash,Gary K. Steinberg
出处
期刊:World Neurosurgery [Elsevier]
卷期号:99: 471-476 被引量:23
标识
DOI:10.1016/j.wneu.2016.12.059
摘要

Embolization has been proposed to reduce the size of the arteriovenous malformation (AVM) nidus in advance of radiosurgical treatment. Embolization followed by radiosurgery for brain AVMs, however, is controversial. We assessed the impact of embolization on nidal size before radiosurgical treatment and evaluated cure rates and complications by using embolization followed by radiosurgery. A retrospective review of our institutional AVM database identified 91 patients treated from 1995 to 2009 with embolization followed by radiosurgery. Pre- and postembolization AVM volumes were measured with angiography, and the modified radiation-based AVM scores (RBAS) also were calculated pre- and postembolization. RBAS determined from pre-embolization volumes were correlated with postradiosurgical obliteration. Median AVM volume declined from 18.8 mL (interquartile range, 10.2–32.2 mL) to 9.9 mL (3.1–19.2 mL) after embolization, P < 0.00003. Median RBAS scores decreased from 2.6 mL (1.8–3.9 mL) to 1.8 mL (1.0–2.8 mL), P < 0.00003. Two of 91 (2.2%) had new fixed deficits after embolization; however, no patient had new disabling deficits (modified Rankin Scale score >2). A total of 71 of 91 (79%) have had >3 years' follow-up, and 40 (56%) had complete obliteration, with 38 (53%) having excellent outcomes (complete obliteration without neurologic decline). Excellent outcome was seen in 90% of patients with modified RBAS score <1, 66% of patients with score 1–1.5, 50% patients with score 1.5–2, and 43% of patients with score >2. These data suggest that embolization of brain AVMs can safely and effectively reduce the treatment volume before radiosurgery. Combined therapy with embolization and radiosurgery does not appear to adversely affect rates of excellent outcome.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
魏莱完成签到,获得积分10
3秒前
gjww应助wp048006采纳,获得10
4秒前
4秒前
祝林斌完成签到 ,获得积分10
4秒前
1siah完成签到,获得积分20
9秒前
10秒前
10秒前
Lucas应助鲁大师采纳,获得10
17秒前
17秒前
柳听白完成签到,获得积分10
20秒前
蒋庆发布了新的文献求助10
20秒前
21秒前
23秒前
gexzygg发布了新的文献求助10
24秒前
26秒前
beizn1214发布了新的文献求助10
27秒前
完美的以寒完成签到 ,获得积分10
27秒前
liuce0307应助不喝奶茶采纳,获得10
28秒前
月光入梦完成签到 ,获得积分10
29秒前
鲁大师发布了新的文献求助10
30秒前
31秒前
静谧180完成签到 ,获得积分10
33秒前
暮夏子完成签到 ,获得积分10
36秒前
38秒前
38秒前
45秒前
最爱不过陈奕迅完成签到,获得积分10
46秒前
威哥完成签到,获得积分10
48秒前
50秒前
SciGPT应助简单的沧海采纳,获得10
50秒前
aaa应助小白采纳,获得20
54秒前
鲁大师完成签到,获得积分10
55秒前
英俊的铭应助cccchen采纳,获得10
57秒前
研友_LJblvL完成签到 ,获得积分10
57秒前
Kyrie发布了新的文献求助10
1分钟前
qfy发布了新的文献求助10
1分钟前
1分钟前
EmmaEmma发布了新的文献求助10
1分钟前
zh发布了新的文献求助10
1分钟前
科研通AI2S应助unite 小丘采纳,获得10
1分钟前
高分求助中
Heun’s Differential Equations 600
《Fundamentals of Power Supply Design》Robert A. Mammano 510
High Wire: How China Regulates Big Tech and Governs Its Economy 260
lingnan science journal vol. 16 250
The philosophy of sports medicine care: an historical review 250
A posteriori勾配制限手法「ポストリミタ」と界面捕獲法THINCを組み合わせた連続・不連続流れを高解像するMUSCLタイプの解法 210
新型航空遥感数据处理技术 200
热门求助领域 (近24小时)
化学 材料科学 医学 生物 有机化学 工程类 生物化学 纳米技术 物理 内科学 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 电极 光电子学 量子力学
热门帖子
关注 科研通微信公众号,转发送积分 2251310
求助须知:如何正确求助?哪些是违规求助? 1900232
关于积分的说明 4742491
捐赠科研通 1689907
什么是DOI,文献DOI怎么找? 856841
版权声明 545512
科研通“疑难数据库(出版商)”最低求助积分说明 453740