ArticlePloS one2017
Microsurgery for intracranial arteriovenous malformation: Long-term outcomes in 445 patients.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 31 citations in OpenAlex.
- Same-Session Hybrid Embolization and Microsurgery Versus Endovascular-Only Treatment for Cerebral Arteriovenous Malformations: A Retrospective Single-Center Comparative Cohort Study.Journal of clinical medicine · 2026Article
- Article
- Learning curve and embolisation strategy in single-stage surgery combined embolisation and microsurgery for brain arteriovenous malformations: results from a nationwide multicentre prospective registry study.Stroke and vascular neurology · 2025Article
- Predictors of Functional Outcome After Microsurgical Resection of Brain Arteriovenous Malformations: A Retrospective Single-Center Study.Journal of clinical medicine · 2025Article
- Spetzler-Martin grade I and II cerebral arteriovenous malformations: a propensity-score matched analysis of resection and stereotactic radiosurgery in adult patients.Neurosurgical review · 2025Article
- The Microsurgical Resection of an Arteriovenous Malformation in a Patient with Thrombophilia: A Case Report and Literature Review.Diagnostics (Basel, Switzerland) · 2024Article
- Letter to the editor: Clinical analysis of surgical outcome of 89 patients having large cerebral arteriovenous malformations.Neurosurgical review · 2024Article
- Clinical features and prognostic factors in patients with intraventricular hemorrhage caused by ruptured arteriovenous malformations.Medicine · 2017Observational
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe management of intracranial arteriovenous malformations(AVMs) poses challenges to the cerebrovascular specialists.
objectiveTo review the long-term outcomes of intracranial AVMs treated with microsurgical resections.
methodsWe performed a retrospective review of 445 patients with intracranial AVMs treated in our hospital from January 1st, 2008 to December 31st, 2014. The extracted data included demographic characteristics, clinical presentations, Spetzler-Martin (SM) grades, Supplemented Spetzler-Martin (SM-Supp) Grades, treatment modalities, long-term outcomes, and obliteration rates. Outcome was assessed with a post-operative modified Rankin Scale (mRS) score at the last follow-up visit.
resultsOf the 445 patients treated with microsurgery, 298 (67.0%) patients initially presented with hemorrhage. Based on the SM grading system, the patients were graded as follows: 83(18.6%) Grade I, 156(35.1%) Grade II, 132(29.7%) Grade III, 61(13.7%) Grade IV and 13(2.9%) Grade V. Overall, 344(77.3%) patients had a favorable outcome (mRS score of 0-2). The favorable outcome for Grade I and II were 92.8% and 85.9%, respectively, sharply reducing to 52.5% in patients with Grade IV and 15.4% in patients with Grade V AVMs. 388(87.2%) patients achieved complete obliteration of the AVMs. 63(14.2%) patients experienced recurrent hemorrhage, and the frequency of rehemorrhage was highest in Grade V patients (77.0%), dropping to 3.6% and 3.8% in patients with Grade I and II lesions, respectively. Permanent neurological deficits occurred in 66(14.8%) patients and death in 35(7.9%) patients. There was no difference of AUROC values between SM grading system and SM-supp grading system (0.726 and 0.734, respectively, p = .715).
conclusionThe Spetzler-Martin grading system is a simple and effective method to estimate the risk of surgery and to evaluate the prognosis. Microsurgical resection for AVMs depends on the SM grades, and the morbidity-mortality rate increases with an increasing SM grade.
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