Evidence map›Paper›PMID 39777180›Full record

ReviewSurgical neurology international2024

Efficacy of radiosurgery with and without angioembolization: A subgroup analysis of effectiveness in ruptured versus unruptured arteriovenous malformations - An updated systematic review and meta-analysis.

Hamza Khan, Abdul Basit Sangah, Roua Nasir, Saad Akhtar Khan, Shazia Saleem Shaikh, Ikhlas Ahmed, Mohad Kamran Abbasi, Asma Ahmed, Dua Siddiqui, Syeda Ayesha Hussain and 2 more

Abstract readReview
In one paragraph

Review in Surgical neurology international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Hamza KhanDepartment of Neurosurgery, Rawalpindi Medical University, Rawalpindi, Pakistan.
Abdul Basit SangahDepartment of Neurosurgery, Liaquat National Hospital, Karachi, Pakistan.
Roua NasirDepartment of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan.
Saad Akhtar KhanDepartment of Neurosurgery, Liaquat National Hospital, Karachi, Pakistan.
Shazia Saleem ShaikhDepartment of Neurosurgery, Liaquat National Hospital, Karachi, Pakistan.
Ikhlas AhmedDepartment of Neurosurgery, Liaquat National Hospital, Karachi, Pakistan.
Mohad Kamran AbbasiDepartment of Neurosurgery, Rehman Medical Institute Peshawar, Peshawar, Pakistan.
Asma AhmedDepartment of Neurosurgery, Rehman Medical Institute Peshawar, Peshawar, Pakistan.
Dua SiddiquiDepartment of Neurosurgery, Liaquat National Hospital, Karachi, Pakistan.
Syeda Ayesha HussainDepartment of Neurosurgery, Rehman Medical Institute Peshawar, Peshawar, Pakistan.
Naveed Zaman AkhunzadaDepartment of Neurosurgery, Rehman Medical Institute Peshawar, Peshawar, Pakistan.
Oswin GodfreyDepartment of Neurosurgery, Sohail Trust Hospital, Karachi, Pakistan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Congenital arterial defects such as cerebral arteriovenous malformations (AVMs) increase brain bleeding risk. Conservative therapy, microsurgical removal, percutaneous embolization, stereotactic radiosurgery (SRS), or a combination may treat this serious disease. This study compares angioembolization with SRS to SRS alone in ruptured or unruptured brain ateriovenous malformations (BAVM) patients. Methods: We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations for this study. Until September 2023, PubMed/Medline, Cochrane, and Clinicaltrials.gov were searched for literature. English-language studies comparing SRS alone to embolization with SRS on ruptured or non-ruptured AVMs that could not be operated on were considered. The Newcastle-Ottawa Scale assessed research study quality. Results: Results included 46 studies with a total of 7077 participants. There was a greater obliteration rate in the SRS-only group (60.4%) than in the embolization plus SRS group (49.73%). Particularly in the SRS-only group, ruptured AVMs showed a noticeably greater obliteration rate than unruptured AVMs ( Conclusion: Our data showed that ruptured brain AVMs had a much greater obliteration rate than unruptured ones, mostly due to SRS alone, without embolization. The aggregated data showed no significant changes, whereas SRS alone decreased radiation-induced alterations and hemorrhagic rates but with increased mortality. SRS alone may have a higher risk-to-reward ratio for nidus obliteration in ruptured brain AVM patients, so it should be used without embolization, although more research is needed to determine the effects of immediate and late complications.

Indexed as

AngioembolizationCerebral arteriovenous malformationsHemorrhagic eventsObliteration rateRadiation-induced changesStereotactic radiosurgery

Identifiers

PMID39777180
PMCPMC11704434

What OpenQuestion holds

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LicenceCC BY-NC-SA
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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.