Stereotactic radiosurgery alone or combined with embolization for brain arteriovenous malformations: a systematic review and meta-analysis

Journal of Neurosurgery
Dylan RussellJason P Sheehan

Abstract

OBJECTIVE Embolization of brain arteriovenous malformations (AVMs) prior to stereotactic radiosurgery (SRS) has been reported to negatively affect obliteration rates. The goal of this systematic review and meta-analysis was to compare the outcomes of AVMs treated with embolization plus SRS (E+SRS group) and those of AVMs treated with SRS alone (SRS group). METHODS A literature review was performed using PubMed to identify studies with 10 or more AVM patients and obliteration data for both E+SRS and SRS groups. A meta-analysis was performed to compare obliteration rates between the E+SRS and SRS groups. RESULTS Twelve articles comprising 1716 patients were eligible for analysis. Among the patients with radiological follow-up data, complete obliteration was achieved in 48.4% of patients (330/681) in the E+SRS group compared with 62.7% of patients (613/978) in the SRS group. A meta-analysis of the pooled data revealed that the obliteration rate was significantly lower in the E+SRS group (OR 0.51, 95% CI 0.41-0.64, p < 0.00001). Symptomatic adverse radiation effects were observed in 6.6% (27/412 patients) and 11.1% (48/433 patients) of the E+SRS and SRS groups, respectively. The annual post-SRS hemorrhage rate was 2.0%-6.5% and 0%-...Continue Reading

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Citations

May 3, 2019·Stroke; a Journal of Cerebral Circulation·Dale DingJason P Sheehan
Jul 31, 2019·CNS Neuroscience & Therapeutics·Sonali S ShaligramHua Su
Dec 21, 2018·Journal of Neurointerventional Surgery·Raoul PopRémy Beaujeux
Aug 30, 2020·Cancer radiothérapie : journal de la Société française de radiothérapie oncologique·J JacobD Pasquier

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