■脑动静脉畸形(AVM)是具有挑战性的血管病变。需要广泛的后续研究来完善治疗算法,并提高这些患者的长期生存率。该研究的目的是评估手术结果,并评估接受脑AVM治疗的患者的总体长期死亡率。
■这项回顾性单中心研究包括191名患有脑AVM的患者,在2012年至2022年期间承认。已经分析了临床和血管造影的特殊性,确定可能影响早期结局和总体长期死亡率的因素.
■在79名接受手术的患者中,51例AVM破裂,全切除68例(86.1%)。深静脉引流与不完全切除有关。女性性别,入院改良的Rankin量表(mRS)>2,以及雄辩的位置是不良结局的独立预测因子.多静脉引流与早期预后恶化的风险较高相关。雄辩的大脑区域受累,保守治疗,年龄越来越大,入院时mRS>2,合并症显著降低了脑AVM患者的生存率。接受介入治疗的患者的生存率明显优于保守治疗的患者。当调整年龄和入院时。
■该研究确定了女性性别,入院时神经功能不良和口才是手术后阴性结局的独立预后因素。接受介入治疗的患者的生存率明显优于保守治疗的患者。我们建议采用量身定制的,积极的管理策略,因为它们显着提高脑AVM患者的长期生存率。
UNASSIGNED: Brain arteriovenous malformations (AVMs) are challenging vascular lesions. Extensive follow-up studies are necessary to refine the therapeutic algorithm, and to improve long-term survival in these patients. The aim of the study was to assess surgical outcomes, and to evaluate overall long-term mortality in patients treated for brain AVMs.
UNASSIGNED: This retrospective single-center study included 191 patients with brain AVMs, admitted between 2012 and 2022. Clinical and angiographical particularities have been analyzed, to identify factors that might influence early outcome and overall long-term mortality.
UNASSIGNED: Out of 79 patients undergoing surgery, 51 had ruptured AVMs with total resection achieved in 68 cases (86.1%). Deep venous drainage was associated with incomplete resection. Female sex, admission modified Rankin Scale (mRS) > 2, and eloquent location were independent predictors of poor outcomes. Multiple venous drainage was associated with a higher risk of worsened early outcome. Eloquent brain region involvement, conservative treatment, increasing age, admission mRS > 2, and comorbidities significantly decrease survival in brain AVM patients. Patients treated with interventional treatments had significantly better survival than the conservatively managed ones, when adjusting for age and admission mRS.
UNASSIGNED: The study identified female sex, poor neurologic status on admission and eloquence as independent prognostic factors for a negative outcome after surgery. Patients who received interventional treatment had significantly better survival than patients managed conservatively. We recommend employing tailored, proactive management strategies as they significantly enhance long-term survival in brain AVM patients.