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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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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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  • presenting/speaker Isabel Hostettler - Klinikum rechts der Isar München, Neurochirurgische Klinik und Poliklinik, München, Deutschland
  • Bernhard Meyer - Klinikum rechts der Isar München, Neurochirurgische Klinik und Poliklinik, München, Deutschland
  • Maria Wostrack - Klinikum rechts der Isar München, Neurochirurgische Klinik und Poliklinik, München, 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. DocP006

doi: 10.3205/20dgnc300, urn:nbn:de:0183-20dgnc3005

Published: June 26, 2020

© 2020 Hostettler et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

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.