Abstract Details

Title Treatment Outcomes of Primary Endovascular Embolization in Patients Randomized in Unruptured Arteriovenous Malformations with a Subgroup Analysis of ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations)

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-007

Objective Treatment Outcomes of Primary Endovascular Embolization in Patients Randomized in Unruptured AVM with a Subgroup Analysis of ARUBA

Background We performed the analysis to evaluate results of primary endovascular embolization in a cohort of BAVM patients treated in a multicenter trial

Design/Methods Patients ≥18 years with unruptured BAVM were enrolled into ARUBA at 39clinical sites in 9countries. We analyzed the rates of stroke and death following primary endovascular embolization in patients who were randomized to interventional therapy. In-person neurological follow-up visits were performed at 6-month intervals during first 2 years and annually, with telephone contacts every 6months thereafter. All baseline imaging studies are reviewed by independent centralized adjudication

Results 30subjects of 116 randomized to interventional treatment underwent only embolization. Mean age was 45.2 SD±11.8; 18 were men. Initial presentation was seizures,headaches or focal deficits in 16,12, &/or 7 subjects. BAVM was graded as Spetzler Martin grade 1,2,3 and 4 in 8,13,8 and 1 subjects. Average number of embolizations per subject was 2.6 range 1.8 - 3.6. Median followup period after embolization was 9.9months SD±8.9. Total of 13 strokes were reported in followup period among 30 subjects (45.6 per 100 person year follow up). Strokes were reported as ischemic, hemorrhagic or both in 6,9 and 0 subjects. Median time interval between randomization and stroke event was 5months. Of the 12 stroke survivors, modified Rankin scale was 0-2 at last follow in 5 subjects. 1year estimated stroke-free survival was 43.5% at 20.6months. Higher proportion of subjects developed stroke in subjects with Spetzler Martin grade 3 and 4. BAVM size and side of the lesion were not linked to the stroke. Stroke and/or death within 1month following procedure occurred in 7.7%

Conclusions Higher rates of adverse outcomes in patients treated with primary endovascular embolization in ARUBA requires careful re-evaluation of this treatment strategy in patients with unruptured BAVM

Authors/Disclosures
Sindhu Sahito, MD (JFK Medical Center) PRESENTER	Dr. Sahito has nothing to disclose.
Omar Saeed, MD	Dr. Saeed has nothing to disclose.
Hamza I. Maqsood, MD (Dept of Neurology)	Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.

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