ABSTRACT

Objectives: Brain arteriovenous malformations (AVMs) represent high-flow vascular lesions made up of a complex network of feeding arteries and draining veins interposed by a nidus and without a capillary bed. The management of the AVMs represents a challenge, and the optimal treatment should be considered based on the particularities of each AVM. This paper aims to provide outcome data for the cohort of patients with AVMs that underwent surgical treatment.

Methods: A retrospective review of patients who presented with AVMs between 2001 and 2019 was conducted. Patients were included if they underwent surgery, preoperative and postoperative angiographic studies were available.

Results: 91 patients were included. The SM grade was 1 in 16 cases (17,6%), 2 in 27 patients (29.7%), 3 in 29 patients (31,9%), 4 in 12 cases (13.2%) and grade 5 in 7 cases (7.7%). In 58 (63.7%) cases the AVMs were ruptured. Complete microsurgical resection was achieved in 82 cases (90.1%). Unruptured AVM (87.9% vs. 63.8% for ruptured AVMs; p = 0.015), low-grade AVM (86% vs. 60.4% for grade III–V AVMs; p = 0.006) and cortical location (79.5% vs. 30.8% for deep AVM; p < 0.0001) were the factors associated with a good outcome on mRS scale.

Conclusions: Microsurgical resection is the curative treatment for AVMs and offers a good functional outcome if selection criteria are met.

摘要

目的：脑动静脉畸形 (AVM) 是一种高流量血管病变，由复杂的供血动脉和引流静脉网络组成，中间有病灶，没有毛细血管床。AVM 的管理是一项挑战，应根据每个 AVM 的特殊性考虑最佳治疗方案。本文旨在为接受手术治疗的 AVM 患者队列提供结果数据。

方法：对 2001 年至 2019 年间出现 AVM 的患者进行了回顾性研究。如果患者接受了手术、术前和术后血管造影研究，则包括在内。

结果：共纳入 91 名患者。SM 等级为 16 例（17.6%）、2 27 例（29.7%）、3 例 29 例（31.9%）、4 例 12 例（13.2%）和 5 级 7 例（ 7.7%）。在 58 (63.7%) 例 AVM 破裂。82 例（90.1%）实现显微手术完全切除。未破裂的 AVM（破裂的 AVM 为 87.9% 与 63.8%；p = 0.015）、低级别 AVM（III-V 级 AVM 为 86% 与 60.4%；p = 0.006）和皮质位置（79.5% 与 30.8%）对于深 AVM；p < 0.0001）是与 mRS 量表良好结果相关的因素。

结论：显微手术切除是 AVM 的治愈性治疗方法，如果符合选择标准，则可提供良好的功能结果。