Srikanth Reddy Boddu MBBS, MRCS, Presenter: Nothing to Disclose

Robert Dineen MBBS, Abstract Co-Author: Nothing to Disclose

Norman McConachie, Abstract Co-Author: Nothing to Disclose

Robert Lenthall, Abstract Co-Author: Nothing to Disclose

Timothy Jaspan MD, Abstract Co-Author: Nothing to Disclose

Allan Christopher Thomas MBBS, Abstract Co-Author: Nothing to Disclose

The management of arteriovenous malformations (AVMs) is quite challenging and often debatable. The aim of our study is to review the management and outcome in patients who are treated at a tertiary referral centre for neuroradiology and neurosurgery between 1995 - 2006.

The management process and outcome of all the patients admitted with brain AVMs to Queen’s Medical Centre Nottingham, a tertiary referral centre, between 1995-2006 were analyzed. Patient case notes were accessed to obtain details of management and treatment related morbidity. The most recent outcome is obtained from the last follow-up visit or by telephone contact with the patient. The outcome was evaluated based on modified Rankin scale (Grade 0 - 5). Grade 6 has been added to our evaluation scale to monitor death.

We reviewed a total of 180 patients during this period. 126 patients have completed their treatment for AVMs. The patients were treated with embolisation (n = 74; 58%), neurosurgery (n = 14; 11%) and radiosurgery (n = 96; 76%). Multimodality management was used (n = 61; 49%) as well as single modality (n = 65; 51%) approaches. In the patients with multimodality approach, 53 patients (87%) had complete obliteration, 6 patients (10%) had more than 90% occlusion and 2 patients (3%) had less than 90% occlusion of AVMs. In the patients with single modality approach 47 patients (72%) had complete obliteration, 10 patients (15%) had more than 90% occlusion and 8 patients (12%) had less than 90% occlusion of their AVMs. The short-term and long-term, treatment related morbidity was 6% (n = 7) and 10% (n=13) respectively. Seventy six (76) patients have completed 60 months post treatment revealing our clinical outcomes to be 63 (83%) as excellent (grade 0&1), 8 (11%) as good (grade 2&3), 1 (1%) as poor (grade 4&5) and 4 (5%) dead.

The results in this series suggest AVMs treated with multimodality approach have higher rates of complete obliteration and excellent outcome with acceptable risk.

Multimodality approach is recommended in the management of brain AVMs to achieve higher rates of complete obliteration and outcome with acceptable risk.

Boddu, S, Dineen, R, McConachie, N, Lenthall, R, Jaspan, T, Thomas, A, A Comparison of Multimodality and Single Modality Management Outcomes of Brain AVMs in the Nottingham Brain AVM Cohort.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5015267.html