Evidence map›Paper›PMID 28973426›Full record

ArticleNeurosurgery2018

Surgical Treatment vs Nonsurgical Treatment for Brain Arteriovenous Malformations in Patients with Hereditary Hemorrhagic Telangiectasia: A Retrospective Multicenter Consortium Study.

Ali Tayebi Meybodi, Helen Kim, Jeffrey Nelson, Steven W Hetts, Timo Krings, Karel G terBrugge, Marie E Faughnan, Michael T Lawton, Brain Vascular Malformation Consortium HHT Investigator Group

Erratum issuedOpen access · greenAbstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurosurgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
1.1field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 28 citations in OpenAlex.

  1. Article
  2. Review
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  6. A challenging case of anemia, respiratory failure and seizures.Acta bio-medica : Atenei Parmensis · 2022
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  9. Childhood stroke.Nature reviews. Disease primers · 2022
    Review
  10. Review
  11. Article
  12. Central nervous system vascular malformations: A clinical review.Annals of clinical and translational neurology · 2021
    Review
  13. Review
  14. Article
  15. Review
  16. Article
  17. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 2 countries.

Ali Tayebi MeybodiDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, California.
Helen KimDepartment of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California.
Jeffrey NelsonDepartment of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California.
Steven W HettsDivision of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California.
Timo KringsDivision of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.
Karel G terBruggeDivision of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.
Marie E FaughnanDivision of Respirology, Keenan Research Centre, and Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Michael T LawtonDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, California.
Brain Vascular Malformation Consortium HHT Investigator Group
Neurological Surgery · USSt. Michael's Hospital · CAUniversity of California, San Francisco · USToronto Western Hospital · CAUniversity of Toronto · CA

Funding

VCRC Administration UnitU54NS065705 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KIM, HELEN · 2009 to 2023
$20.8M
NINDS NIH HHS U54 NS065705
6 · The paper itself

Abstract

backgroundCerebral arteriovenous malformations (AVMs) are common in patients with hereditary hemorrhagic telangiectasia (HHT). However, due to the rarity of HHT and little published evidence of outcomes from management of brain AVMs in this disease, current international HHT guidelines recommend an individualized approach. Specifically, the outcomes for surgical vs nonsurgical management of these lesions have not been reported to date.

objectiveTo report long-term outcomes of surgical resection of brain AVMs in HHT patients compared to outcomes in nonsurgically treated patients.

methodsFrom the database of the Brain Vascular Malformation Consortium HHT project, 19 patients with 20 resected AVMs (group 1) and 22 patients with 33 AVMs who received nonsurgical treatment (group 2) were studied. The groups were retrospectively reviewed for changes in functional status (modified Rankin Scale score) during the follow-up period.

resultsDuring the follow-up period, 9% of patients in group 1 suffered from worsening of functional status, whereas this figure was 16% for group 2 (P > .05). Functional outcomes were not statistically different between the 2 groups at the latest follow-up (P > .05).

conclusionHHT patients treated surgically for brain AVMs appear to have long-term functional outcomes comparable to nonsurgical (including observational) therapy with fewer unfavorable outcomes. It is therefore reasonable to consider surgical resection as a management option in the multidisciplinary team's individualized treatment strategy for HHT patients with brain AVMs.

Indexed as

AdolescentAdultAgedBrainCentral Nervous System Vascular MalformationsChildChild, PreschoolDatabases, FactualFemaleHumansInfantIntracranial Arteriovenous MalformationsMaleMiddle AgedRetrospective StudiesTelangiectasia, Hereditary HemorrhagicArteriovenous malformationAVM gradingBrain vascular malformation consortiumEmbolizationHereditary hemorrhagic telangiectasiaMicrosurgical resectionRadiosurgeryRendu-Osler-Weber disease

Identifiers

PMID28973426
PMCPMC5732039
OpenAlexW2736078343

What OpenQuestion holds

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Registered trials

None linked

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.