Effect of Prior Embolization on Outcomes After Stereotactic Radiosurgery for Pediatric Brain Arteriovenous Malformations: An International Multicenter Study
| Autor: | David Mathieu, Paul P. Huang, Huai-Che Yang, Inga S. Grills, Ching-Jen Chen, Shih-Wei Tzeng, Jennifer D. Sokolowski, Caleb E Feliciano, Thomas J. Buell, Gene Barnett, Hideyuki Kano, L. Dade Lunsford, Jason P. Sheehan, Rebecca M. Burke, Douglas Kondziolka, Darrah Sheehan, Natasha Ironside, Kimball Sheehan, Robert M. Starke, Dale Ding, Christian Iorio-Morin, Cheng-Chia Lee, Kathryn N. Kearns |
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| Rok vydání: | 2021 |
| Předmět: |
Intracranial Arteriovenous Malformations
medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology Radiosurgery 03 medical and health sciences 0302 clinical medicine parasitic diseases Occlusion medicine Humans Embolization Child Retrospective Studies business.industry Vascular malformation Brain Arteriovenous malformation Multimodal therapy medicine.disease Treatment Outcome Pediatric brain Cohort Surgery Neurology (clinical) Radiology business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Neurosurgery. 89:672-679 |
| ISSN: | 1524-4040 0148-396X |
| DOI: | 10.1093/neuros/nyab245 |
| Popis: | BACKGROUND Pediatric brain arteriovenous malformations (AVMs) are a significant cause of morbidity but the role of multimodal therapy in the treatment of these lesions is not well understood. OBJECTIVE To compare the outcomes of stereotactic radiosurgery (SRS) with and without prior embolization for pediatric AVMs. METHODS We retrospectively evaluated the International Radiosurgery Research Foundation pediatric AVM database. AVMs were categorized, based on use of pre-embolization (E + SRS) or lack thereof (SRS-only). Outcomes were compared in unadjusted and inverse probability weight (IPW)-adjusted models. Favorable outcome was defined as obliteration without post-SRS hemorrhage or permanent radiation-induced changes (RIC). RESULTS The E + SRS and SRS-only cohorts comprised 91 and 448 patients, respectively. In unadjusted models, the SRS-only cohort had higher rates of obliteration (68.5% vs 43.3% |
| Databáze: | OpenAIRE |
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