ArticleNeurointervention2017
Effectiveness of Preradiosurgical Embolization with NBCA for Arteriovenous Malformations - Retrospective Outcome Analysis in a Japanese Registry of 73 Patients (J-REAL study).
Article in Neurointervention, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- The role of procedural factors on the outcomes of embolization followed by radiosurgery for the treatment of brain arteriovenous malformations: systematic review and proportional meta-analyses.Acta neurochirurgica · 2024Pooled it
- Review
- A systematic review and meta-analysis of microsurgery and radiosurgery outcomes in low-grade cerebral arteriovenous malformations: Obliteration rates, morbidity, and mortality.Brain & spine · 2026Review
- Transarterial Embolization for the Management of Brain Arteriovenous Malformations: A Systematic Review.Journal of neuroendovascular therapy · 2025Review
- Embolotherapy of Head and Neck Lesions: Basics and Clinical Tips.Interventional radiology (Higashimatsuyama-shi (Japan) · 2024Review
- Head and Neck Arteriovenous Malformations: Clinical Manifestations and Endovascular Treatments.Interventional radiology (Higashimatsuyama-shi (Japan) · 2023Review
- Liquid Embolic Agents for Endovascular Embolization: A Review.Gels (Basel, Switzerland) · 2023Review
- State of the Art in the Role of Endovascular Embolization in the Management of Brain Arteriovenous Malformations-A Systematic Review.Journal of clinical medicine · 2022Review
- Gamma Knife Radiosurgery For Brain Vascular Malformations: Current Evidence And Future Tasks.Therapeutics and clinical risk management · 2019Review
Corrections and comments
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Authors and funding
9 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeRecent reports have posed doubts about the effect of preradiosurgical embolization in brain arteriovenous malformation (AVM) because it makes the planning of stereotactic radiosurgery (SRS) difficult and has the risk of recanalization out of the target. We investigated whether the performance and quality of embolization may influence the success of SRS based on a retrospective case cohort study. MATERIALS AND
methodsSeventy-three patients who underwent embolization followed by SRS between 2003 and 2012 in eight institutes with neurointerventionists were considered. They were divided into the following two groups at 3 years of follow up after the final SRS: "successful occlusion group" (S group), with radiologically complete occlusion of AVM; and "non-successful occlusion group" (N group) with persistent remnant nidus or abnormal vascular networks. Patient background, AVM profile, embolization performance grade and complications were compared in each group. The quality of embolization was evaluated with the new grading system: embolization performance grade (E grade), specializing the achievement of nidus embolization. E grade A was defined as sufficient nidus embolization with more than half of the total number of feeders achieving nidus penetration. E grade B was defined as less than half achievement of nidus embolization, and E grade C was defines as failure to perform nidus embolization.
resultsForty-three patients were included in the S group, and 29 patients were included in the N group. The size and Spetzler-Martin grade of AVM and the rate of diffuse type was higher in the N group without statistical significance. The embolization performance level according to E grade indicated a significantly higher rate of successful embolization with more than 50% of nidus penetration in the S group (P<0.001). This difference was also confirmed in the subanalysis for limited cases, excluding smaller AVMs with complete occlusion with SRS alone (P=0.001).
conclusionThe cause of the unsuccessful result of post-embolization SRS might be the large, diffuse angioarchitecture, but proper embolization with a high rate of nidus penetration to avoid recanalization is more important. Effective embolization is essential to contribute to and promote the effect of radiosurgery.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.