ArticleStroke (Hoboken, N.J.)2023
Increase in Ruptured Cerebral Arteriovenous Malformations and Mortality in the United States: Unintended Consequences of the ARUBA Trial?
Article in Stroke (Hoboken, N.J.), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Risk of Future Hemorrhage From Unruptured Brain Arteriovenous Malformations: The Multicenter Arteriovenous Malformation Research Study (MARS).JAMA neurology · 2025Article
- Early analysis of data from the British & Irish Brain Arteriovenous Malformations Registry (BIBAR).Brain & spine · 2025Article
- Perspectives on Brain Arteriovenous Malformations From the Surgical Battlefield.Stroke (Hoboken, N.J.) · 2024Article
- Associations of Brain Arteriovenous Malformation-Related Factors with Epileptic Seizure Presentations.Diagnostics (Basel, Switzerland) · 2024Article
- Natural history and clinical manifestation of Pediatric Brain Arteriovenous Malformations.Journal of Korean Neurosurgical Society · 2024Article
- Trends in AVM-Associated Intracranial Hemorrhage in the United States, 2000-2019.JAMA neurology · 2024Article
- Multi-Stage Treatment for Spetzler-Martin Grades III, IV, and V Arteriovenous Malformations: Preoperative Embolization and Microsurgical Resection in a Consecutive Series of 250 Patients.Journal of clinical medicine · 2023Article
- In Response to: Dicpinigaitis AJ, Ogulnick JV, Mayer AS, Gandhi CD, Al-Mufti F. Increase in Ruptured Cerebral Arteriovenous Malformations and in the United States: Unintended Consequences of the ARUBA Trial?Stroke (Hoboken, N.J.) · 2023Article
- In Response to: Dicpinigaitis AJ, Ogulnick JV, Mayer AS, Gandhi CD, Al-Mufti F. Increase in Ruptured Cerebral Arteriovenous Malformations and Mortality in the United States: Unintended Consequences of the ARUBA Trial.Stroke (Hoboken, N.J.) · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The findings of the ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformation) trial, which determined that medical management was superior to prophylactic interventional therapy for the treatment of unruptured cerebral arteriovenous malformations (cAVMs), remain polarizing and controversial. Methods: Adult cAVM patient admissions were identified in the National Inpatient Sample from 2009 to 2019. The incidence of cAVM rupture and in-hospital mortality were compared between the pre- (2009-2013) and post-ARUBA trial eras (2014-2019) using complex samples-weighted estimates and multivariable logistic regression analyses. A control cohort composed of an alternate pathology (ruptured and unruptured cerebral aneurysms) was also assessed during the study period to evaluate potential bias. Results: Among 121 415 hospitalizations for cAVM during the study period, 31 389 (25.9%) were admissions for ruptured malformations. The incidence of ruptured cAVM increased in the post-ARUBA trial era (13.3% versus 34.4%; Conclusion: The incidence of ruptured cAVM increased following 2014, potentially a reflection of a paradigm shift to conservative and noninterventional management strategies in patients with unruptured cAVM. Further studies may be necessary to exclude other confounders contributing to this rise.
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