![](/images/graphics-bg.png)
Stereotactic Radiosurgery with Neoadjuvant Embolization of Larger Arteriovenous Malformations : An Institutional Experience
Joint Authors
Starke, Robert M.
Jabbour, Pascal M.
Dalyai, Richard Tyler
Gordon, David S.
Rosenwasser, Robert H.
Gonzalez, L. Fernando
Chalouhi, Nohra
Tjoumakaris, Stavropoula I.
Ghobrial, George
Theofanis, Thana
Dumont, Aaron S.
Source
Issue
Vol. 2014, Issue 2014 (31 Dec. 2014), pp.1-8, 8 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2014-01-22
Country of Publication
Egypt
No. of Pages
8
Main Subjects
Abstract EN
Objective.
This study investigates the safety and efficacy of a multimodality approach combining staged endovascular embolizations with subsequent SRS for the management of larger AVMs.
Methods.
Ninety-five patients with larger AVMs were treated with staged endovascular embolization followed by SRS between 1996 and 2011.
Results.
The median volume of AVM in this series was 28 cm3 and 47 patients (48%) were Spetzler-Martin grade IV or V.
Twenty-seven patients initially presented with hemorrhage.
Sixty-one patients underwent multiple embolizations while a single SRS session was performed in 64 patients.
The median follow-up after SRS session was 32 months (range 9–136 months).
Overall procedural complications occurred in 14 patients.
There were 13 minor neurologic complications and 1 major complication (due to embolization) while four patients had posttreatment hemorrhage.
Thirty-eight patients (40%) were cured radiographically.
The postradiosurgery actuarial rate of obliteration was 45% at 5 years, 56% at 7 years, and 63% at 10 years.
In multivariate analysis, larger AVM size, deep venous drainage, and the increasing number of embolization/SRS sessions were negative predictors of obliteration.
The number of embolizations correlated positively with the number of stereotactic radiosurgeries (P<0.005).
Conclusions.
Multimodality endovascular and radiosurgical approach is an efficacious treatment strategy for large AVM.
American Psychological Association (APA)
Dalyai, Richard Tyler& Theofanis, Thana& Starke, Robert M.& Chalouhi, Nohra& Ghobrial, George& Jabbour, Pascal M.…[et al.]. 2014. Stereotactic Radiosurgery with Neoadjuvant Embolization of Larger Arteriovenous Malformations : An Institutional Experience. BioMed Research International،Vol. 2014, no. 2014, pp.1-8.
https://search.emarefa.net/detail/BIM-462062
Modern Language Association (MLA)
Dalyai, Richard Tyler…[et al.]. Stereotactic Radiosurgery with Neoadjuvant Embolization of Larger Arteriovenous Malformations : An Institutional Experience. BioMed Research International No. 2014 (2014), pp.1-8.
https://search.emarefa.net/detail/BIM-462062
American Medical Association (AMA)
Dalyai, Richard Tyler& Theofanis, Thana& Starke, Robert M.& Chalouhi, Nohra& Ghobrial, George& Jabbour, Pascal M.…[et al.]. Stereotactic Radiosurgery with Neoadjuvant Embolization of Larger Arteriovenous Malformations : An Institutional Experience. BioMed Research International. 2014. Vol. 2014, no. 2014, pp.1-8.
https://search.emarefa.net/detail/BIM-462062
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-462062