ArticleJournal of Korean Neurosurgical Society2026
Factors Associated with Clinical Outcomes of Repeat Gamma Knife Radiosurgery for Cerebral Arteriovenous Malformations.
Article in Journal of Korean Neurosurgical Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveGamma knife radiosurgery (GKRS) is an established treatment for cerebral arteriovenous malformations (AVMs). However, incomplete obliteration after initial GKRS continues to pose a risk of hemorrhage. Although repeat GKRS is used as a salvage treatment, specific guidelines and safety profiles remain to be fully defined. By analyzing the clinical outcomes of repeat GKRS in 60 patients with incompletely obliterated AVMs, this study aims to test the hypothesis that optimizing treatment-related variables, particularly the timing of retreatment, may improve the safety and efficacy of repeat GKRS for residual AVMs.
methodsThis retrospective study included 60 patients with AVMs who underwent repeat GKRS between 1992 and 2024. Clinical charts, radiologic imaging, and treatment parameters were analyzed to assess complete obliteration, hemorrhage after repeat GKRS, and adverse radiation effects (AREs). Kaplan-Meier survival analysis was performed to estimate obliteration and hemorrhage rates. Univariate and multivariate analyses were conducted to identify factors associated with complete obliteration, hemorrhage, and AREs.
resultsComplete obliteration was achieved in 40 patients (66.7%). The actuarial obliteration rates were 1.7%, 22.5%, 53.5%, and 73.9% at 1, 3, 5, and 10 years, respectively. A target volume reduction rate >50% (p=0.004; hazard ratio [HR], 3.002; 95% confidence interval [CI], 1.414-6.374) and lower initial Spetzler-Martin (SM) grade (p=0.008; HR, 0.608; 95% CI, 0.420-0.879) were independently associated with complete obliteration. Six patients (10%) experienced hemorrhage after repeat GKRS, corresponding to an annual hemorrhage rate of 2.3%. AVMs located in the posterior fossa (p=0.005; HR, 80.958; 95% CI, 3.891-1684.629) and hemorrhage prior to repeat GKRS (p=0.020; HR, 19.075; 95% CI, 1.576-230.805) were independently associated with hemorrhage. Seven patients (11.7%) experienced AREs after repeat GKRS. Larger repeat target volume (p=0.042; odds ratio [OR], 3.170; 95% CI, 1.044-9.626) and a shorter interval of months between initial and repeat treatment (p=0.040; OR, 0.823; 95% CI, 0.683-0.991) were independently associated with AREs.
conclusionRepeat GKRS for incompletely obliterated AVMs may provide favorable obliteration rates. Adequate volume response after initial GKRS and lower SM grades may predict successful complete obliteration. Patients with prior hemorrhage and AVMs located in the posterior fossa may be at greater risk of hemorrhage after repeat GKRS. Larger treatment volume and shorter intervals between initial and repeat GKRS were associated with AREs. Extending the interval between initial and repeat GKRS may reduce the risk of AREs and provide a safer approach for treating incompletely obliterated AVMs.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.