Evidence map›Paper›PMID 42673144›Full record

ArticleEuropean stroke journal2026

Predictors of complete obliteration and favourable outcome after single-modality treatment for low-grade arteriovenous malformations: a multicentre study.

Angelica M Fuentes, Salem M Tos, Natasha Ironside, Georgios Mantziaris, Yuki Shinya, Basel Musmar, Hamza Adel Salim, Nimer Adeeb, Christopher S Ogilvy, Douglas Kondziolka and 60 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European stroke journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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5 · Who and what money

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70 authors.

Angelica M FuentesDepartment of Neurosurgery, University of Virginia, Charlottesville, VA, United States.ORCID 0009-0003-2931-4150
Salem M TosDepartment of Neurosurgery, University of Virginia, Charlottesville, VA, United States.
Natasha IronsideDepartment of Neurosurgery, University of Virginia, Charlottesville, VA, United States.
Georgios MantziarisDepartment of Neurosurgery, University of Virginia, Charlottesville, VA, United States.
Yuki ShinyaDepartment of Neurosurgery, University of Virginia, Charlottesville, VA, United States.
Basel MusmarDepartment of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, United States.
Hamza Adel SalimDepartment of Neuroradiology, MD Anderson Medical Center, Houston, TX 77030, United States.ORCID 0000-0002-5208-8425
Nimer AdeebDepartment of Neurosurgery, Louisiana State University, New Orleans, LA, United States.ORCID 0000-0002-8668-7629
Christopher S OgilvyNeurological Service, BIDMC, Harvard Medical School, Boston, MA, United States.
Douglas KondziolkaDepartment of Neurosurgery, New York University Grossman School of Medicine, New York, NY, United States.
Ali AlarajDepartment of Neurosurgery, University of Illinois in Chicago, Chicago, IL, United States.ORCID 0000-0002-1491-4634
Min S ParkDepartment of Neurosurgery, Loyola University Stritch School of Medicine, Maywood, IL, United States.
Adam A DmytriwNeuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
Hussein ZeineddineDepartment of Neurosurgery, UT Health Sciences Center at Houston, McGovern Medical School, Houston, TX, United States.
Finn MccarthyDepartment of Neurosurgery, University of Illinois in Chicago, Chicago, IL, United States.
Hussam Abou-Al-ShaarDepartment of Neurosurgery, UT Health Sciences Center at Houston, McGovern Medical School, Houston, TX, United States.
Ahmed AbdelsalamDepartment of Neurosurgery, University of Miami, Miami, FL, United States.
Mustafa BaskayaDepartment of Neurosurgery, University of Wisconsin School of Medicine, Madison, WI, United States.
Cagdas AtaogluDepartment of Neurosurgery, University of Wisconsin School of Medicine, Madison, WI, United States.
Anthony Sanchez-FortezaDepartment of Neurosurgery, University of Illinois in Chicago, Chicago, IL, United States.
Muhammed Amir EssibayiMontefiore Einstein Cerebrovascular Research Lab and Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, United States.ORCID 0000-0001-8325-2382
Abdullah KelesDepartment of Neurosurgery, University of Wisconsin School of Medicine, Madison, WI, United States.
Sandeep MuramNeurological Service, BIDMC, Harvard Medical School, Boston, MA, United States.
Howard RiinaDepartment of Neurosurgery, New York University Grossman School of Medicine, New York, NY, United States.
Arwin RezaiDepartment of Neurosurgery, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.
Sahin HanaliogluDepartment of Neurosurgery, Brigham and Women Hospital, Harvard Medical School, Boston, MA, United States.ORCID 0000-0003-4988-4938
Ufuk ErginogluDepartment of Neurosurgery, University of Wisconsin School of Medicine, Madison, WI, United States.
Johannes PöppeDepartment of Neurosurgery, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.
Davide SimonatoDepartment of Neuroradiology, Oxford University Hospitals NHS Foundation Trust, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom.
Yan-Lin LiDepartment of Neuroradiology, Oxford University Hospitals NHS Foundation Trust, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom.
Sandeep KandregulaDepartment of Neurosurgery, University of Pennsylvania, Philadelphia, PA, United States.
Dhairya A LakhaniDepartment of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States.ORCID 0000-0001-7577-1887
Christoph J GriessenauerDepartment of Neurosurgery, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.
Rahim Abo KasemDepartment of Neurosurgery, Division of Neuroendovascular Surgery, Medical University of South Carolina, Charleston, SC, United States.
Alejandro M SpiottaDepartment of Neurosurgery, Division of Neuroendovascular Surgery, Medical University of South Carolina, Charleston, SC, United States.ORCID 0000-0002-7142-5538
Ajit S PuriDivision of Neurointerventional Radiology, Department of Radiology, University of Massachusetts Medical Center, Worcester, MA, United States.
Jasmeet SinghDivision of Neurointerventional Radiology, Department of Radiology, University of Massachusetts Medical Center, Worcester, MA, United States.
Anna Luisa KuhnDivision of Neurointerventional Radiology, Department of Radiology, University of Massachusetts Medical Center, Worcester, MA, United States.
Jan Karl BurkhardtDepartment of Neurosurgery, University of Pennsylvania, Philadelphia, PA, United States.ORCID 0000-0002-3726-4048
Robert M StarkeDepartment of Neurosurgery, University of Miami, Miami, FL, United States.
Laligam N SekharDepartment of Neurosurgery, University of Washington, Seattle, WA, United States.
Michael R LevittDepartment of Neurosurgery, University of Washington, Seattle, WA, United States.ORCID 0000-0003-3612-3347
David AltschulMontefiore Einstein Cerebrovascular Research Lab and Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, United States.
Neil HaranhalliMontefiore Einstein Cerebrovascular Research Lab and Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, United States.
Malia McAvoyDepartment of Neurosurgery, University of Washington, Seattle, WA, United States.
Paul ForemanDepartment of Neurosurgery, Orlando Health Neuroscience, Orlando, FL, United States.
Osama O ZaidatDepartment of Neurosurgery, Mercy Health, St Vincent Medical Center, Bridgeport, CT, United States.
Mohammad H AlMajaliDepartment of Neurosurgery, Mercy Health, St Vincent Medical Center, Bridgeport, CT, United States.
Hakeem J ShakirDepartment of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.
Alfred Pokmeng SeeDepartment of Neurosurgery, Boston Children's Hospital, Boston, MA, United States.
Adib A AblaDepartment of Neurosurgery, University of Miami, Miami, FL, United States.
Aashay PatelDepartment of Neurosurgery, University of Florida, Gainesville, FL, United States.
Andrew NguyenDepartment of Neurosurgery, University of Florida, Gainesville, FL, United States.
Matthew J KochDepartment of Neurosurgery, University of Florida, Gainesville, FL, United States.
Visish M SrinivasanDepartment of Neurosurgery, University of Pennsylvania, Philadelphia, PA, United States.
Peng Roc ChenDepartment of Neurosurgery, UT Health Sciences Center at Houston, McGovern Medical School, Houston, TX, United States.
Spiros BlackburnDepartment of Neurosurgery, UT Health Sciences Center at Houston, McGovern Medical School, Houston, TX, United States.
Ketan R BulsaraDepartment of Neurosurgery, University of Connecticut, Mansfield, CT, United States.
Peter KanDepartment of Neurosurgery, University of Texas Medical Branch, Galveston, TX, United States.ORCID 0000-0001-6649-4128
Louis KimDepartment of Neurosurgery, University of Washington, Seattle, WA, United States.
Omar ChoudhriDepartment of Neurosurgery, University of Pennsylvania, Philadelphia, PA, United States.
Stavropoula I TjoumakarisDepartment of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, United States.
Pascal JabbourDepartment of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, United States.ORCID 0000-0002-8965-2413
Amey SavardekarDepartment of Neurosurgery, Louisiana State University, New Orleans, LA, United States.
Hugo H CuellarDepartment of Neurosurgery, Louisiana State University, New Orleans, LA, United States.
Michael T LawtonDepartment of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, United States.
Bharat GuthikondaDepartment of Neurosurgery, Louisiana State University, New Orleans, LA, United States.
Jacques MorcosDepartment of Neurosurgery, UT Health Sciences Center at Houston, McGovern Medical School, Houston, TX, United States.
Jason P SheehanDepartment of Neurosurgery, University of Virginia, Charlottesville, VA, United States.
MISTA Consortium

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPatient and arteriovenous malformation (AVM) characteristics that portend success after treatment for low-grade brain AVMs remain unknown. PATIENTS AND

methodsWe utilised the MISTA multicentre registry to identify patients with Spetzler-Martin (SM) grade I or II AVMs treated with stand-alone curative-intent intervention (resection, stereotactic radiosurgery [SRS] or endovascular embolisation). Bivariate and multivariable analyses were performed to identify patient and AVM characteristics predictive of complete obliteration or favourable outcome (complete obliteration without new permanent deficit or post-treatment haemorrhage).

resultsA total of 522 patients were included (292 microsurgery, 152 SRS, 78 embolisation). Complete obliteration rates differed between microsurgery (95.9%), SRS (75.0%) and embolisation (71.8%) (P < .001); among patients classified as cured, digital subtraction angiography (DSA) confirmed obliteration in 96.1%, 75.9% and 52.4%, respectively. Favourable outcome was achieved in 89.4%, 64.5% and 67.9% (P < .001). In adjusted models for obliteration, elderly age (odds ratio [OR] 0.49, P = .022), larger nidus (OR 0.64, P = .005) and compacted morphology (OR 1.93, P = .019) were independent predictors overall; paediatric age predicted incomplete obliteration after microsurgery (OR 0.05, P = .045), and elderly age (OR 0.19, P = .001) and larger nidus (OR 0.59, P = .015) after SRS. For favourable outcome, SM grade II overall (adjusted OR [aOR] 0.58, P = .031) and elderly age after SRS (aOR 0.31, P = .019) were independent negative predictors. DISCUSSION: Low-grade AVMs showed high rates of complete obliteration, though DSA-confirmed rates were substantially lower after embolisation, underscoring the importance of angiographic confirmation.

conclusionThe predictors identified in this study may help guide management when 2 or 3 of the primary treatment options carry clinical equipoise.

Indexed as

Embolization, TherapeuticIntracranial Arteriovenous MalformationsRadiosurgeryAdolescentAdultAgedAngiography, Digital SubtractionChildFemaleHumansMaleMicrosurgeryMiddle AgedRegistriesTreatment OutcomeYoung AdultAVM obliterationcerebral arteriovenous malformationscomplication ratesendovascularfunctional outcomesresectionSpetzler–Martin grade I and IIstereotactic radiosurgery

Identifiers

PMID42673144
PMCPMC13528858

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