Evidence map›Paper›PMID 40016553›Full record

ArticleNeurosurgical review2025

Spetzler-Martin grade I and II cerebral arteriovenous malformations: a propensity-score matched analysis of resection and stereotactic radiosurgery in adult patients.

Salem M Tos, Mahmoud Osama, Georgios Mantziaris, Bardia Hajikarimloo, Nimer Adeeb, Sandeep Kandregula, Adam A Dmytriw, Hamza Adel Salim, Basel Musmar, Kareem El Naamani and 50 more

Abstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. Review
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

60 authors.

Salem M TosDepartment of Neurosurgery, University of Virginia, Charlottesville, VA, USA.
Mahmoud OsamaDepartment of Neurosurgery, University of Virginia, Charlottesville, VA, USA.
Georgios MantziarisDepartment of Neurosurgery, University of Virginia, Charlottesville, VA, USA.
Bardia HajikarimlooDepartment of Neurosurgery, University of Virginia, Charlottesville, VA, USA.
Nimer AdeebDepartment of Neurosurgery, Louisiana State University Health Science Center, Shreveport, LA, USA.
Sandeep KandregulaNeuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Adam A DmytriwNeuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Hamza Adel SalimDepartment of Radiology, Louisiana State University, Shreveport, LA, USA.
Basel MusmarDepartment of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Kareem El NaamaniDepartment of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Christopher OgilvyDivision of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Douglas KondziolkaDepartment of Neurosurgery, New York University Grossman School of Medicine, New York, NY, USA.
Ahmed AbdelsalamDepartment of Neurosurgery, University of Miami, Miller School of Medicine, Miami, FL, USA.
Deepak KumbhareDepartment of Neurosurgery, McGovern Medical School, UT Health Sciences Center at Houston, Houston, TX, USA.
Sanjeev GummadiDepartment of Neurosurgery, McGovern Medical School, UT Health Sciences Center at Houston, Houston, TX, USA.
Cagdas AtaogluDepartment of Neurosurgery, University of Wisconsin School of Medicine, Madison, WI, USA.
Ufuk ErginogluDepartment of Neurosurgery, University of Wisconsin School of Medicine, Madison, WI, USA.
Muhammed Amir EssibayiMontefiore Einstein Cerebrovascular Research Laband, Department of Neurological Surgery, Montefiore Medical Centeraq, Albert Einstein College of Medicine, New York, NY, USA.
Abdullah KelesDepartment of Neurosurgery, University of Wisconsin School of Medicine, Madison, WI, USA.
Sandeep MuramDivision of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Daniel SconzoDivision of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Howard RiinaDepartment of Neurosurgery, University of Miami, Miller School of Medicine, Miami, FL, USA.
Arwin RezaiDepartment of Neurosurgery, Paracelsus Medical University, Christian Doppler Klinik, Salzburg, Austria.
Johannes PöppeDepartment of Neurosurgery, Paracelsus Medical University, Christian Doppler Klinik, Salzburg, Austria.
Rajeev D SenDepartment of Neurosurgery, University of Washington, Seattle, WA, USA.
Omar AlwakaaDivision of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Christoph J GriessenauerDepartment of Neurosurgery, Paracelsus Medical University, Christian Doppler Klinik, Salzburg, Austria.
Pascal JabbourDepartment of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Stavropoula I TjoumakarisDepartment of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Jan-Karl BurkhardtNeuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Robert M StarkeDepartment of Neurosurgery, University of Miami, Miller School of Medicine, Miami, FL, USA.
Mustafa BaskayaDepartment of Neurosurgery, University of Wisconsin School of Medicine, Madison, WI, USA.
Laligam N SekharDepartment of Neurosurgery, University of Washington, Seattle, WA, USA.
Michael R LevittDepartment of Neurosurgery, University of Washington, Seattle, WA, USA.
David J AltschulMontefiore Einstein Cerebrovascular Research Laband, Department of Neurological Surgery, Montefiore Medical Centeraq, Albert Einstein College of Medicine, New York, NY, USA.
Neil HaranhalliMontefiore Einstein Cerebrovascular Research Laband, Department of Neurological Surgery, Montefiore Medical Centeraq, Albert Einstein College of Medicine, New York, NY, USA.
Malia McAvoyDepartment of Neurosurgery, University of Washington, Seattle, WA, USA.
Assala AslanDepartment of Radiology, Louisiana State University, Shreveport, LA, USA.
Abdallah AbushehabDepartment of Plastic Surgery, Mayo Clinic Hospital, Rochester, MN, USA.
Christian SwaidDepartment of Neurosurgery, McGovern Medical School, UT Health Sciences Center at Houston, Houston, TX, USA.
Adib AblaDepartment of Neurosurgery, University of Miami, Miller School of Medicine, Miami, FL, USA.
Christopher StapletonNeuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Matthew KochDepartment of Neurosurgery, University of Florida, Gainesville, FL, USA.
Visish M SrinivasanNeuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Peng R ChenDepartment of Neurosurgery, McGovern Medical School, UT Health Sciences Center at Houston, Houston, TX, USA.
Spiros BlackburnDepartment of Neurosurgery, McGovern Medical School, UT Health Sciences Center at Houston, Houston, TX, USA.
Mark J DannenbaumDepartment of Neurosurgery, McGovern Medical School, UT Health Sciences Center at Houston, Houston, TX, USA.
Omar ChoudhriNeuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Bryan PukenasNeuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Darren OrbachNeurointerventional Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Edward SmithDepartment of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Markus MöhlenbruchInterventional Neuroradiology, Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
Ali AlarajDepartment of Neurosurgery, University of Illinoisinaq, Chicago, IL, USA.
Ali Aziz-SultanDepartment of Neurosurgery, Brigham and Women Hospital, Harvard Medical School, Boston, MA, USA.
Aman B PatelDepartment of Neurosurgery, New York University Grossman School of Medicine, New York, NY, USA.
Hugo H CuellarDepartment of Neurosurgery, McGovern Medical School, UT Health Sciences Center at Houston, Houston, TX, USA.
Michael LawtonDepartment of Neurosurgery, Barrow, Neurological Institute, Phoenix, AZ, USA.
Jacques MorcosDepartment of Neurosurgery, McGovern Medical School, UT Health Sciences Center at Houston, Houston, TX, USA.
Bharat GuthikondaDepartment of Neurosurgery, McGovern Medical School, UT Health Sciences Center at Houston, Houston, TX, USA.
Jason SheehanDepartment of Neurosurgery, University of Virginia, Charlottesville, VA, USA. jsheehan@virginia.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cerebral arteriovenous malformations (AVMs) are congenital vascular anomalies that can lead to severe complications, including hemorrhage and neurological deficits. This study compares the outcomes of microsurgical resection and stereotactic radiosurgery (SRS) for SM grade I and II AVMs. Out of a large multicenter registry, we identified 180 matched patients with SM grade I and II AVMs treated with either microsurgical resection or SRS between 2010 and 2023. The primary outcomes were AVM obliteration rates and complications; secondary outcomes included neurological status and functional outcomes measured by the modified Rankin Scale (mRS). Propensity score matching (PSM) was utilized to ensure comparability between treatment groups. After PSM, 90 patients were allocated to each treatment group. Significant differences were observed in complete obliteration rates, with resection achieving higher rates compared to SRS in overall cases (97.8% vs. 60.0%, p < 0.001), unruptured AVMs (100% vs. 58.3%, p < 0.001), and ruptured AVMs (95.2% vs. 61.9%, p < 0.001). Functional improvement rates were similar between the groups for overall cases (67.2% in resection vs. 66.7% in SRS, p = 0.95), unruptured AVMs (55.2% in resection vs. 55.6% in SRS, p > 0.9), and ruptured AVMs (78.1% in resection vs. 74.1% in SRS, p = 0.7). Symptomatic complication rates were identical between the groups (11.1% each, p > 0.9), while permanent complication rates were comparable (6.7% in resection vs. 5.6% in SRS, p = 0.8). Resection demonstrated significantly higher complete obliteration rates compared to SRS across all cases, including unruptured and ruptured AVMs. Functional improvement rates were similar between the two treatment groups, with no significant differences in symptomatic or permanent complication rates.

Indexed as

Intracranial Arteriovenous MalformationsMicrosurgeryNeurosurgical ProceduresRadiosurgeryAdultAgedFemaleHumansMaleMiddle AgedPropensity ScoreRetrospective StudiesTreatment OutcomeYoung AdultAVM obliterationCerebral arteriovenous malformationsComplication ratesFunctional outcomesResectionSpetzler-Martin grade I and IIStereotactic radiosurgery

Identifiers

PMID40016553
PMCPMC11868255

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