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Endovascular Treatment Accounts for a Change in Brain Arteriovenous Malformation Natural History Risk

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机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Beijing Neurosurg Inst, Beijing 100050, Peoples R China; [2]Capital Med Univ, Beijing Tiantan Hosp, Beijing Neurosurg Inst, 6 Tiantan Xili, Beijing 100050, Peoples R China
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关键词: cerebral hemorrhage vascular malformations embolization

摘要:
This study estimated the risk and rates of intracranial hemorrhage (ICH) in patients harboring brain arteriovenous malformation (BAVM) after endovascular embolization. One hundred and forty-four consecutive patients with BAVM treated with endovascular embolization between 1998 and 2003 were retrospectively reviewed. The risk of ICH subsequent to endo vascular embolization was studied using Kaplan-Meier curves. We reviewed 144 patients with BAVM treated with endovascular embolization. Two hundred and sixty-nine procedures were performed, 69 were performed with silk sutures, 18 with coils, 137 with NBCA and 36 with Onyx18. Twenty-three (16.0%) patients were treated with additional gamma-knife radiosurgery and one (0.7%) with additional surgical AVM excision. Complete obliteration of BAVMs was achieved in 20 patients (13.9%). During a mean follow-up of 5.9 years for the ICH group and 6.9 years for the non-ICH group, hemorrhages occurred in 11 (17.7%) of the ICH patients and in nine (11%) of the non-ICH group (p>0.1). The annual risk of hemorrhage was 3.0% and 1.6%, respectively. In the multivariate regression model, the adjusted relative risk (RR) for hemorrhage at initial presentation was 1.6 (95% CI 1.2-3.2; p>0.1). Deep venous drainage, male sex, age or AVM size were not significantly associated with subsequent hemorrhage. ICH and non-ICH groups did not differ in progression to subsequent ICH after endovascular embolization (log-rank X-2=1.339, p>0.1) in survival analyses. The overall annual hemorrhage risk for all patients after endovascular embolization was 2.1%. Endo vascular embolization alone or combined with gamma-knife radiosurgery or surgical treatment are able to decrease ICH occurrence compared to abstention.

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出版当年[2009]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 核医学
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 核医学
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出版当年[2008]版:
Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Q4 CLINICAL NEUROLOGY
最新[2023]版:
Q3 CLINICAL NEUROLOGY Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Q4 CLINICAL NEUROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2008版] 出版当年五年平均 出版前一年[2007版] 出版后一年[2009版]

第一作者:
第一作者机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Beijing Neurosurg Inst, Beijing 100050, Peoples R China; [2]Capital Med Univ, Beijing Tiantan Hosp, Beijing Neurosurg Inst, 6 Tiantan Xili, Beijing 100050, Peoples R China
通讯作者:
通讯机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Beijing Neurosurg Inst, Beijing 100050, Peoples R China; [2]Capital Med Univ, Beijing Tiantan Hosp, Beijing Neurosurg Inst, 6 Tiantan Xili, Beijing 100050, Peoples R China
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