Artikel
Single-centre analysis of functional outcome in patients with arteriovenous malformation
Einzelzentrische Analyse des funktionellen Outcomes bei Patienten mit arteriovenöser Malformation
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Veröffentlicht: | 26. Juni 2020 |
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Gliederung
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Objective: Arteriovenous malformations (AVM) are vascular malformations. Functional outcome differs depending on whether an AVM has bled or not and which treatment modality was used. We evaluated all AVMs treated at our institution.
Methods: Retrospective analysis of a prospectively collected database of all consecutive patients seen in our neurosurgical department between 2006 and 2018. We measured functional outcome using the modified Ranking Scale (mRS) and defined favourable functional outcome as an mRS of 0-2.
Results: A total of 183 patients with cerebral AVMs were included. Mean age was 44.42 years (SD 17.7), 37.7% were female. 112 (61.2%) patients presented with a haemorrhage due to the AVM. 71 (38.3%) patients were treated surgically-only, 10 (5.5%) with embolization-only, 12 (6.6%) with radiosurgery-only and 69 (37.7%) with a combination. In the univariable analysis age, female sex and haemorrhage vs no haemorrhage were associated with favourable outcome on follow-up. In the multivariable analysis age (OR 0.96; 95%CI 0.93-0.98: p-value=0.002), Spetzler Martin Grade (OR 0.64; 95%CI 0.42-0.97; p=0.04) and haemorrhage from AVM (OR 0.14; 95%CI 0.04-0.55; p=0.005) were all inversely associated with functional outcome on follow-up. Surgery did not negatively influence functional outcome on follow-up (p=0.85). 73/181 patients (40.3%) improved the mRS subgroup, 6 demonstrated a decline in mRS subgroup. Of 126/183 where a detailed follow-up was available, 92.1% indicated a complete recovery or improvement of symptoms.
Conclusion: Most patients with AVMs improve considerably during follow-up. Patients undergoing surgery do not have worse functional outcome compared to other modalities.