Endovascular Treatment for Low-Grade (Spetzler-Martin I–II) Brain Arteriovenous Malformations

Article Figures & Data

Table 1:

Baseline characteristics and results of endovascular treatment^{^a}

	Total (n = 224)	Ruptured BAVMs (n = 136)	Unruptured BAVMs (n = 88)	P Value
Age (yr)	37.8 ± 16	37.9 ± 17.7	37.6 ± 13.3	.087
Male	127 (57%)	81 (60%)	46 (52%)	.282
Presentation				NA
Hemorrhage	136 (60%)	136 (100%)	0 (0%)
Seizure	42 (19%)	0 (0%)	42 (48%)
Incidental	37 (17%)	0 (0%)	37 (42%)
Other	9 (4%)	0 (0%)	9 (10%)
Initial mRS score				.0001
Good (0–2)	178 (79%)	91 (67%)	87 (99%)
Poor (3–5)	46 (21%)	45 (33%)	1 (1%)
BAVM location				.001
Cortical and subcortical	176 (79%)	96 (71%)	80 (90%)
Deep	19 (8%)	15 (11%)	4 (5%)
Infratentorial	29 (13%)	25 (18%)	4 (5%)
Eloquent area	77 (34%)	55 (40%)	22 (25%)	.017
Spetzler-Martin grade				.361
I	71 (32%)	40 (29%)	31 (35%)
II	153 (68%)	96 (71%)	57 (65%)
Mean nidus diameter (cm)	2.1 ± 1.1	1.9 ± 1.1	2.4 ± 1.1	.0001
Deep venous drainage	45 (20%)	32 (24%)	13 (15%)	.126
Venous ectasia	54 (24%)	27 (20%)	27 (31%)	.061
Arterial aneurysm	20 (9%)	14 (10%)	6 (7%)	.475
Intranidal aneurysm	42 (19%)	33 (24%)	9 (10%)	.020
Mean No. of procedures	1.6 ± 0.9	1.4 ± 0.8	1.8 ± 1.1	.003
Duration of follow-up angiography (mo)	9.7 ± 11.9	8.7 ± 10.4	11.3 ± 13.8	.117
Angiographic result				.091
Complete exclusion	205 (92%)	128 (94%)	77 (88%)
Remnant	19 (8%)	8 (6%)	11 (12%)	1.000
Post-EVT AVM surgery	7 (3%)	4 (3%)	3 (4%)	NA
Post-EVT radiosurgery	8 (4%)	2 (2%)	6 (8%)	NA
Severe post-EVT hematoma	11 (5%)	7 (5%)	4 (5%)	1.000
Significant post-EVT ischemia	5 (2%)	4 (3%)	1 (1%)	.651
Postop outcome (mRS)				.001
Good (0–2)	179 (80%)	96 (71%)	83 (94%)
Poor (3–5)	44 (19%)	40 (29%)	4 (5%)
Mortality (6)	1 (0.4%)	0 (0%)	1 (1%)
Improved/unchanged mRS score	211 (94%)	127 (93%)	85 (96%)	1.000

Table 2:

Cure rate according to location of AVM^{^a}

	Total	Complete Exclusion	Remnant	P Value^{^b}
Location				.338
Cortical and subcortical	176 (100%)	159 (90.3%)	17 (9.7%)
Deep	19 (100%)	19 (100%)	0 (0%)
Infratentorial	29 (100%)	27 (93.1%)	2 (6.9%)
Eloquent	77 (100%)	76 (98.7%)	1 (1.3%)	.004
Noneloquent	147 (100%)	129 (87.8%)	18 (12.2%)

Table 3:

Summary of endovascular treatment for low-grade brain arteriovenous malformations^{^a}

Author, Year	No. of Patients	Morbidity	Mortality	Cure Rate
Maimon et al, 2010¹⁰	8	0 (0%)	0 (0%)	5 (63%)
van Rooji WJ et al, 2012⁷	20	0 (0%)	0 (0%)	19 (96%)
Xu et al, 2011¹⁹	16	1 (6.3%)	0 (0%)	9 (56%)
Saatci et al, 2011¹⁸	158	4 (2.5%)	1 (0.6%)	155 (98%)
Abud et al, 2011¹²	8	1 (12.5%)	0 (0%)	8 (100%)
Durst et al, 2015²⁰	5	NA	0 (0%)	5 (100%)
Our study, 2018	224	12 (5.4%)	1 (0.4%)	206 (92%)
Total	439	18 (4.1%)	2 (0.5%)	407 (93%)