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71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

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Impact of feeding arteries on haemorrhage risk in brain arteriovenous malformations

Einfluss der zuführenden Arterien auf das Blutungsrisiko von zerebralen arteriovenösen Malformationen

Meeting Abstract

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  • presenting/speaker Michael Eibach - Universitätsklinikum Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
  • Sae-Yeon Won - Universitätsklinikum Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
  • Johanna Quick-Weller - Universitätsklinikum Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
  • Joachim Berkefeld - Universitätsklinikum Frankfurt am Main, Neuroradiologie, Frankfurt am Main, Deutschland
  • Jürgen Konczalla - Universitätsklinikum Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
  • Eva Herrmann - Johann Wolfgang Goethe-Universität Frankfurt am Main, Biostatistik und mathematische Modellierung, Frankfurt am Main, Deutschland
  • Volker Seifert - Universitätsklinikum Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
  • Gerhard Marquardt - Universitätsklinikum Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
  • Nazife Dinc - Universitätsklinikum Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocV154

doi: 10.3205/20dgnc154, urn:nbn:de:0183-20dgnc1544

Veröffentlicht: 26. Juni 2020

© 2020 Eibach et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: Angioarchitectur and hemodynamic conditions play an important role in the hemorrhage risk in brain arteriovenous malformations. Knowledge of hemodynamics of blood flow is required for risk assessment and treatment options. The purpose of this study was to investigate whether the number or the origin of arterial feeders are risk factors for bleeding in AVMs.

Methods: We retrospectively examined all patients who were admitted to our hospital with a diagnosed brain AVM between December 2005 and February 2018.

Digital subtraction angiography was used to identify the number and origin of arterial feeders. We counted the number of the major brain arteries. Single Feeder was defined as one major artery feeding an AVM nidus. Furthermore, we evaluated the presence of aneurysms and the number of draining veins.

We dichotomized the patients according their hemorrhage status at the initial diagnosis and compare the different potential impact factors.

Results: We included a total of 180 patients in our study. Patients with ruptured AVM had significant more often a single arterial feeder (51.9 % vs. 34.3 %) and a single draining vein (54.3 % vs. 21.2 %) than patients with unruptured AVM on first diagnosis. In addition, a supply from cerebellar arteries (28.4 % vs 11.1 %) was significant more often identified in ruptured AVM than in unruptured AVM. The presence of aneurysms did not differ between ruptured and unruptured AVMs. In the multivariable analysis, single feeder (OR 2.17), single draining vein (OR 3.34) and a supply from cerebellar arteries (OR 2.97) were independent risk factors for hemorrhage in AVM.

Conclusion: Our results suggested that a single arterial feeder, cerebellar feeder and a single draining vein are independent risk factors for hemorrhage in brain AVMs. These variables should be considered in the decision process for treating or not treating unruptured AVMs.