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首页> 外文期刊>Journal of clinical neuroscience: official journal of the Neurosurgical Society of Australasia >Surgical and radiosurgical results of the treatment of cerebral arteriovenous malformations
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Surgical and radiosurgical results of the treatment of cerebral arteriovenous malformations

机译：脑动静脉畸形治疗的外科和放射外科结果

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摘要

Microsurgical resection of a cerebral arteriovenous malformation (AVM) allows for an immediate therapeutic cure. Stereotactic radiosurgery (SRS) is a reasonable alternative for inoperable or high-risk lesions requiring treatment. Few series evaluate overall results that include data from both modalities as they more often focus on their treatment method of choice. In this study, we evaluated our AVM database of 129 patients seen over the past eight years at our institution: 73 were treated with microsurgery (57%) while 37 (29%) were treated with SRS. We reviewed angiographic obliteration rates, complication rates, and outcome data, excluding seven patients treated with SRS as they did not have at least two years of angiographic follow-up. Patients undergoing microsurgery had smaller AVM (mean 2.2 cm compared to 3.5 cm for SRS), a smaller proportion of eloquent AVM (53% compared to 83% for SRS), a greater proportion of AVM with superficial drainage only (75% compared to 40% for SRS), and more grade 1 and 2 AVM (78% compared to 17% for SRS). The overall obliteration rate was 80%: 92% for microsurgery and 50% for SRS. The latter increased to 92% for AVM <3 cm, but the obliteration rate was 18% for those AVM >3 cm. Transient complications, including post-SRS hemorrhage, were seen in 11% of patients overall (8% after microsurgery, 17% after SRS). At follow-up, 53% of patients had improved, 37% remained the same, 7% had become worse and 3% had died. As a result of post-SRS hemorrhage, a greater proportion of patients was worse or had died after SRS (20%) compared to those who had been treated with microsurgery (5%).
机译：脑动静脉畸形（AVM）的显微外科切除术可以立即治愈。立体定向放射外科手术（SRS）是无法手术或需要治疗的高危病变的合理替代方案。很少有系列评估包括两种方式的数据在内的总体结果，因为它们更常关注自己选择的治疗方法。在这项研究中，我们评估了我们机构过去8年中观察到的129例患者的AVM数据库：73例接受了显微外科手术（57％），而37例（29％）接受了SRS治疗。我们回顾了血管造影的闭塞率，并发症发生率和结果数据，不包括7例接受SRS治疗的患者，因为他们没有至少两年的血管造影随访。接受显微外科手术的患者的AVM较小（平均2.2厘米，SRS为3.5厘米），雄辩的AVM比例较小（53％，而SRS为83％），仅表浅引流的AVM比例较大（75％，而40％ SRS为％）和更高的1级和2级AVM（78％，而SRS为17％）。总体清除率是80％：显微外科手术为92％，SRS为50％。对于AVM <3 cm，后者增加到92％，但是对于那些大于3 cm的AVM，闭塞率为18％。总患者中有11％出现了短暂并发症，包括SRS术后出血（显微手术后为8％，SRS后为17％）。随访时，有53％的患者病情好转，37％的患者病情好转，7％的病情恶化，3％的患者死亡。 SRS术后出血的结果是，与接受显微外科手术治疗的患者（5％）相比，更大比例的患者在SRS后更糟或死亡（20％）。

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