Evidence map›Paper›PMID 40407914›Full record

SynthesisChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2025

Stereotactic radiosurgery treatment of pediatric arteriovenous malformations: a PRISMA systematic review and meta-analysis.

Garrett W Thrash, Riley Ethan Evans, Yifei Sun, Anne C Roberts, Cameron Derryberry, Andrew T Hale, Somnath Das, Hunter Boudreau, Jordan A George, Travis J Atchley and 4 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Review
  3. 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

14 authors.

Garrett W Thrash *Heersink School of Medicine, University of Alabama at Birmingham, FOT Suite, 1720 2nd Ave S, Birmingham, AL, 35294, USA. Garrettthrash54@gmail.com.
Riley Ethan Evans *Heersink School of Medicine, University of Alabama at Birmingham, FOT Suite, 1720 2nd Ave S, Birmingham, AL, 35294, USA.
Yifei SunHeersink School of Medicine, University of Alabama at Birmingham, FOT Suite, 1720 2nd Ave S, Birmingham, AL, 35294, USA.
Anne C RobertsHeersink School of Medicine, University of Alabama at Birmingham, FOT Suite, 1720 2nd Ave S, Birmingham, AL, 35294, USA.
Cameron DerryberryHeersink School of Medicine, University of Alabama at Birmingham, FOT Suite, 1720 2nd Ave S, Birmingham, AL, 35294, USA.
Andrew T HaleDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Somnath DasDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Hunter BoudreauDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Jordan A GeorgeDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Travis J AtchleyDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Jeffrey P BlountDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Brandon G RocqueDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
James M JohnstonDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Jesse G JonesDepartment of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStereotactic radiosurgery (SRS) is considered a safe definitive treatment for pediatric arteriovenous malformations (AVMs) upon indicated presentations. There are no published guidelines by the International Stereotactic Radiosurgery Society (ISRS) detailed with indications or characteristics that warrant SRS, other than the guideline that SRS is a safe and efficacious treatment for pediatric AVMs. SRS is performed using either Gamma Knife (GK) or Linear Accelerator (LINAC). This systematic review aims to uncover treatment, differences in GK and LINAC outcomes, and AVM characteristics that lead to high obliteration rates and suggest future studies to determine treatment decisions, raise obliteration rates, and lower complication rates in SRS treatment of pediatric AVMs.

methodsWe performed a systematic review according to PRISMA guidelines across PubMed, Embase, and SCOPUS utilizing search terms related to pediatric patients, AVMS, and SRS. We collected data from the 32 full-text studies and 4 abstracts that met inclusion criteria. Subsequent pooled analysis was performed on GK vs LINAC obliteration rates, followed by sub-cohort analysis of all SRS patients with hemorrhagic presentation, Spetzler-Martin (SM) Grade, and prior procedure and their effect on obliteration rates.

resultsThe 36 studies reported 3425 patients, with a slight male preponderance (1662 patients, 48.5%). The obliteration analysis included 2834 patients that met follow-up criteria and contained obliteration data. The weighted mean age was 12.63 years. Pooled cohort analysis found no significant difference in obliteration proportions when comparing GK to LINAC (P = 0.7449), with an overall obliteration rate of 63% in patients with at least 1 year follow-up. The sub-cohort analysis of all patients treated with SRS revealed that presentation with AVM hemorrhage was associated with increased obliteration (CE: RR = 1.22 [95%CI = 1.09-1.35; RE: RR = 1.22, 95%CI = 10.6-1.40; prediction interval = 1.07-1.38) with low heterogeneity (I

conclusionSRS is a safe and effective treatment for pediatric AVMs. This study suggests that there are no differences in obliteration between GK and LINAC, with increased obliteration in patients with hemorrhage at presentation and procedures prior to SRS treatment. Further multicenter, prospective studies are necessary to dictate future treatment decisions.

Indexed as

Intracranial Arteriovenous MalformationsRadiosurgeryChildHumansTreatment OutcomeInternational Stereotactic Radiosurgery SocietyPediatric arteriovenous malformationsStereotactic radiosurgery treatment

Identifiers

PMID40407914
PMCPMC12102109

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.