Third Stereotactic Radiosurgery for Residual Arteriovenous Malformations: A Retrospective Multicenter Study - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Neurosurgery Année : 2023

Third Stereotactic Radiosurgery for Residual Arteriovenous Malformations: A Retrospective Multicenter Study

S. Pikis
  • Fonction : Auteur
G. Mantziaris
  • Fonction : Auteur
A. Shaaban
  • Fonction : Auteur
M. Protopapa
  • Fonction : Auteur
Z. Xu
  • Fonction : Auteur
  • PersonId : 1210868
  • IdHAL : zongboxu
A. Niranjan
  • Fonction : Auteur
Z. Wei
  • Fonction : Auteur
L. W. Tang
  • Fonction : Auteur
R. Liscak
  • Fonction : Auteur
J. May
  • Fonction : Auteur
N. Martinez Moreno
  • Fonction : Auteur
R. Martinez Álvarez
  • Fonction : Auteur
S. Peker
  • Fonction : Auteur
Y. Samanci
  • Fonction : Auteur
A. M. Nabeel
  • Fonction : Auteur
W. A. Reda
  • Fonction : Auteur
S. R. Tawadros
  • Fonction : Auteur
K. Abdelkarim
  • Fonction : Auteur
A. M. N. El-Shehaby
  • Fonction : Auteur
R. M. Emad
  • Fonction : Auteur
A. H. Elazzazi
  • Fonction : Auteur
V. Padmanaban
  • Fonction : Auteur
F. J. Jareczek
  • Fonction : Auteur
K. M. Cockroft
  • Fonction : Auteur
D. Lunsford
  • Fonction : Auteur
J. P. Sheehan
  • Fonction : Auteur

Résumé

BACKGROUND AND OBJECTIVES: There are no studies evaluating the efficacy and safety of more than 2 stereotactic radiosurgery (SRS) procedures for cerebral arteriovenous malformations (AVM). The aim of this study was to provide evidence on the role of third single-session SRS for AVM residual. METHODS: This multicenter, retrospective study included patients managed with a third single-session SRS procedure for an AVM residual. The primary study outcome was defined as AVM nidus obliteration without AVM bleeding or symptomatic radiation-induced changes (RIC). Secondary outcomes evaluated were AVM obliteration, AVM hemorrhage, asymptomatic, and symptomatic RIC. RESULTS: Thirty-eight patients (20/38 [52.6%] females, median age at third SRS 34.5 [IQR 20] years) were included. The median clinical follow-up was 46 (IQR 14.8) months, and 17/38 (44.7%) patients achieved favorable outcome. The 3-year and 5-year cumulative probability rates of favorable outcome were 23% (95% CI = 10%-38%) and 53% (95% CI = 29%-73%), respectively. The cumulative probability of AVM obliteration at 3 and 5 years after the third SRS was 23% (95% CI = 10%-37%) and 54% (95% CI = 29%-74%), respectively. AVM bleeding occurred in 2 patients, and 1 of them underwent subsequent resection. The cumulative probability rate of post-SRS AVM hemorrhage remained constant at 5.3% (95% CI = 1%-16%) during the first 5 years of follow-up. Transient symptomatic RIC managed conservatively occurred in 5/38 patients (13.2%) at a median time of 12.5 (IQR 22.5) months from third SRS. Radiation-induced cyst formation was noted in 1 patient (4.2%) 19 months post-SRS. No mortality, radiation-associated malignancy, or permanent symptomatic RIC was noted during follow-up. CONCLUSION: A third single-session SRS to treat a residual intracranial AVM offers obliteration in most patients. The risk of RIC was low, and these effects were transient. While not often required, a third SRS can be performed in patients with persistent residual AVMs.
Fichier non déposé

Dates et versions

hal-04660614 , version 1 (24-07-2024)

Identifiants

Citer

S. Pikis, G. Mantziaris, C. Dumot, A. Shaaban, M. Protopapa, et al.. Third Stereotactic Radiosurgery for Residual Arteriovenous Malformations: A Retrospective Multicenter Study. Neurosurgery, 2023, ⟨10.1227/neu.0000000000002805⟩. ⟨hal-04660614⟩
8 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Mastodon Facebook X LinkedIn More