Microsurgical resection versus conservative management for unruptured brain arteriovenous malformations in the ARUBA era: A systematic review and meta-analysis.
Chris S Aboujudom, Simon Levinson, Spyridon Karadimas
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In 30 seconds
This systematic review and meta-analysis evaluated outcomes of microsurgical resection versus conservative management for unruptured brain arteriovenous malformations (AVMs). The analysis included 14 studies and found that microsurgical resection resulted in a 61% reduction in the hazard of stroke or death (HR 0.39) compared to conservative management, with a functional disability rate of 9.6% versus 15.1% in the conservative arm.
Key findings
- Microsurgical resection resulted in a functional disability rate of 9.6% compared to 15.1% in conservative management.
- Angiographic obliteration was achieved in 97.7% of patients undergoing microsurgical resection.
- The pooled stroke or death rate was 3.7%, significantly lower than the ARUBA benchmark of 10.1%.
- Microsurgical resection demonstrated a 61% reduction in stroke or death hazard (HR 0.39).
Why it matters
The findings suggest that microsurgical resection may offer better outcomes in terms of stroke, death, and functional disability for patients with low-grade AVMs compared to conservative management, highlighting the need for careful consideration of treatment options.