Open AccessGrades of brain arteriovenous malformations and risk of hemorrhage and death
Author(s) -
Stefani Marco A.,
Sgarabotto Ribeiro Diego,
Mohr Jay P.
Publication year - 2019
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.723
Subject(s) - medicine , arteriovenous malformation , stroke (engine) , cohort , conservative treatment , intracranial arteriovenous malformations , surgery , conservative management , randomized controlled trial , pediatrics , cerebral angiography , angiography , mechanical engineering , engineering
Abstract Objective To assess the relationship of the grade of unruptured and untreated Brain Arteriovenous Malformations ( AVM s), with the risk of subsequent stroke and death during follow‐up. Methods This prospective study was drawn from a cohort of adult patients with unruptured AVM s, who participated in the conservative treatment arm (medical management only for headache or seizures) of the randomized clinical trial of unruptured brain AVM s ( ARUBA study). The grade of AVM s (Spetzler–Martin scale) was dichotomized into categories: AVM s of grades I and II were considered low grade; AVM s of grades III and IV were considered high grade. There were no grade V AVM patients in ARUBA . The primary outcome was symptomatic stroke (hemorrhagic or ischemic – documented by imaging) or death. Results The conservative treatment group had 123 patients (“as treated” analysis). 71 (57.7%) had lesions characterized for this analysis as low‐grade lesions and 52 (42.2%) as high grade. From the total of 10 (8.13%) primary outcomes, three occurred (4.22%) in low‐grade AVM s and seven (13.46%) in high‐grade AVM s ( P = 0.0942). Interpretation Statistical analysis of the cohort of patients with unruptured and untreated AVM s from ARUBA study showed that the graduation categories (Spetzler–Martin grades) were not associated with the outcome of subsequent stroke or death.