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2013 Research Abstract

Prediction of Arteriovenous Malformation (AVM) Recurrences in Pediatric Populations Using Characteristics of Vessel Compactness and Presence of Deep Venous Drainage

Investigators: Peter Yang

Mentor: Richard C. E. Anderson, MD, Neurological Institute

Abstract: The recurrence of brain arteriovenous malformations (AVMs) after microsurgical has been well documented in literature. Particularly, pediatric patients have been shown to have higher risk of AVM recurrence after initial negative post-operative angiography when compared to adults. Recently elucidated risk factors for AVM recurrence in pediatric patients include AVMs with low compactness scores and deep venous drainage. Our study sought to identify both uncontrollable and controllable risk factors in predicting residual/recurrent (R/R) AVMs in a group of 41 pediatric patients at Columbia University Medical Center from 1991 to 2012 who were treated by microsurgical resection with and without pre-operative embolization. We reviewed characteristics of AVM morphology including venous drainage pattern, AVM location, and AVM compactness as well as embolization status. We found that that the lack of pre- operative embolization was a significant risk factor for R/R AVMs in our patient sample. Of note is that we did not find an independent association between low compactness and deep AVMs with R/R AVMs, which were previously shown to predict recurrence. This is also a significant finding because in these previous works, low compactness and deep venous draining AVMs were associated with recurrences in AVMs that did not receive pre-operative embolization. Our findings suggest the added benefit of pre-operative embolization to preventing R/R AVMs in pediatric patients.

Last Updated: 1/28/14

Updated on January 28, 2014.