Recurrent Brain Arteriovenous Malformations (AVMs): A Systematic Review

Thomas J. Sorenson, Waleed Brinjikji, Carlo Bortolotti, Gabriel Kaufmann, Giuseppe Lanzino

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective: Risk factors for the recurrence of surgically excised brain arteriovenous malformations (AVMs) are poorly understood. In addition, ideal follow-up imaging paradigms to catch AVM recurrences are not well defined. We present a systematic review on risk factors for the recurrence of surgically resected AVMs and identify potential theories of recurrence. Methods: A literature search was performed by a reference librarian, and after screening, 14 case reports and 16 case series were left for inclusion in the review. All possible data were abstracted by 2 authors, and the results were tabulated and descriptive statistics (mean, range; and proportions) were reported. No formal statistical analysis was performed as part of this study. Results: Systematic review of the literature revealed 73 patients with a surgically resected AVM that recurred. The average age of first AVM presentation was 13.8 years, and most patients presented with hemorrhage (90%). After angiographically confirmed complete surgical resection, average time to AVM recurrence was 4.2 years. Rate of recurrence was 2.7% in adult series or case reports (n = 8). When we analyzed only pediatric case reports or series (n = 12), the average rate of recurrence was 9.5% but was as high as almost 14% in a series with compulsory short-term follow-up serial imaging. Four (5.5%) patients experienced re-recurrence of AVM after complete surgical excision of first AVM recurrence. Conclusions: AVM recurrence after complete surgical resection is a recognized risk that occurs primarily in children. Follow-up imaging within 1 year of surgery is strongly indicated for pediatric patients with surgically resected AVMs, even with postoperative angiographically confirmed complete excision.

Original languageEnglish (US)
JournalWorld Neurosurgery
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Arteriovenous Malformations
Recurrence
Brain
Pediatrics
Librarians
Hemorrhage

Keywords

  • Arteriovenous malformation
  • Cerebrovascular
  • Endovascular
  • Neurosurgery
  • Recurrent
  • Review
  • Vascular

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Recurrent Brain Arteriovenous Malformations (AVMs) : A Systematic Review. / Sorenson, Thomas J.; Brinjikji, Waleed; Bortolotti, Carlo; Kaufmann, Gabriel; Lanzino, Giuseppe.

In: World Neurosurgery, 01.01.2018.

Research output: Contribution to journalArticle

Sorenson, Thomas J. ; Brinjikji, Waleed ; Bortolotti, Carlo ; Kaufmann, Gabriel ; Lanzino, Giuseppe. / Recurrent Brain Arteriovenous Malformations (AVMs) : A Systematic Review. In: World Neurosurgery. 2018.
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abstract = "Objective: Risk factors for the recurrence of surgically excised brain arteriovenous malformations (AVMs) are poorly understood. In addition, ideal follow-up imaging paradigms to catch AVM recurrences are not well defined. We present a systematic review on risk factors for the recurrence of surgically resected AVMs and identify potential theories of recurrence. Methods: A literature search was performed by a reference librarian, and after screening, 14 case reports and 16 case series were left for inclusion in the review. All possible data were abstracted by 2 authors, and the results were tabulated and descriptive statistics (mean, range; and proportions) were reported. No formal statistical analysis was performed as part of this study. Results: Systematic review of the literature revealed 73 patients with a surgically resected AVM that recurred. The average age of first AVM presentation was 13.8 years, and most patients presented with hemorrhage (90{\%}). After angiographically confirmed complete surgical resection, average time to AVM recurrence was 4.2 years. Rate of recurrence was 2.7{\%} in adult series or case reports (n = 8). When we analyzed only pediatric case reports or series (n = 12), the average rate of recurrence was 9.5{\%} but was as high as almost 14{\%} in a series with compulsory short-term follow-up serial imaging. Four (5.5{\%}) patients experienced re-recurrence of AVM after complete surgical excision of first AVM recurrence. Conclusions: AVM recurrence after complete surgical resection is a recognized risk that occurs primarily in children. Follow-up imaging within 1 year of surgery is strongly indicated for pediatric patients with surgically resected AVMs, even with postoperative angiographically confirmed complete excision.",
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