Evidence map›Paper›PMID 40111720›Full record

SynthesisTranslational stroke research2025

Long-Term Outcomes of Stereotactic Radiosurgery Focused Treatment of Brain Arteriovenous Malformations Based on Rupture Status: A Systematic Review and Meta-Analysis.

Meah T Ahmed, Anand Kaul, Joanna Roy, Basel Musmar, Santiago D Mendoza-Ayús, Morena P Koorie, Cheritesh R Amaravadi, Antony A Fuleihan, Stavropoula I Tjoumakaris, Michael R Gooch and 2 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Translational stroke research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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.

Meah T AhmedDepartment of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Anand KaulDepartment of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Joanna RoyDepartment of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Basel MusmarDepartment of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Santiago D Mendoza-AyúsDepartment of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Morena P KoorieDepartment of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Cheritesh R AmaravadiDepartment of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Antony A FuleihanDepartment of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Stavropoula I TjoumakarisDepartment of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Michael R GoochDepartment of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Robert H RosenwasserDepartment of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Pascal JabbourDepartment of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA. pascal.jabbour@jefferson.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Stereotactic radiosurgery (SRS) is a non-invasive treatment option for brain arteriovenous malformations (bAVMs). However, SRS cures are delayed, making it less favorable for higher risk ruptured bAVMs (rbAVMs) than unruptured (ubAVMs). This systematic review and meta-analysis explores the long-term outcomes of SRS-focused protocols for rbAVMs and ubAVMs. This study adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Literature search was conducted using PubMed, Ovid Medline, Scopus, and hand-search on January 30th, 2025. The inclusion criteria encompassed studies: distinguishing cohorts by rupture status, reporting post-SRS outcomes, and without overlapping series. Pooled analysis was performed from 24 articles using DerSimonian-Laird random effects models. Subgroup and meta-regression analyses were also conducted. All analyses were performed using R. For rbAVMs, the pooled rupture, obliteration, and mortality rates were 7.14% (95% CI: 5.76%-8.64%), 65.0% (95% CI: 57.2%-72.4%), and 0.87% (95% CI: 0.00%-5.14%), respectively, and for ubAVMs, 6.13% (95% CI: 4.71%-7.69%), 59.5% (95% CI: 51.3%-67.3%), and 0.89% (95% CI: 0.00%-3.82%), respectively. Subgroup meta-analyses of rupture rates and obliteration rates showed no significant differences based on prior treatments (Q = 2.47, p = 0.48; Q = 4.34, p = 0.23; respectively) or volume-staging protocols (Q = 4.90, p = 0.18; Q = 1.12, p = 0.77, respectively). Meta-regression analysis for rbAVMs demonstrated a positive correlation between intranidal aneurysms and rupture rate (p < 0.05, R

Indexed as

Intracranial Arteriovenous MalformationsRadiosurgeryHumansTreatment OutcomeBrain Arteriovenous MalformationsRadiosurgeryRupturedUnruptured

Identifiers

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Registered trials

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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.