Abstract Details

Title Comparison of Intervention with Medical Treatment if Young Patients with Unruptured Brain Arteriovenous Malformation

Topic Neuro Trauma, Critical Care, and Sports Neurology

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

Poster/Presentation
Number 4-009

Objective Comparison of intervention with medical treatment if young patients with Unruptured Brain Arteriovenous Malformation.

Background The decision regarding treatment of unruptured brain arteriovenous malformation (BAVM) is controversial but treatment may be beneficial in young adults.

Design/Methods We analyzed data from A Randomized trial of Unruptured Brain Arteriovenous malformations (ARUBA)
aims to compare the risk of stroke and/or death in adult BAVM patients according to age strata (<45 years and ≥45 years) who were allocated to either medical management or interventional therapy. The risk according to hazards ratio [HR] and 95% confidence interval [CI] for stroke and/or death associated with interventional therapy was calculated using Cox proportional hazards analysis.

Results A total 226 and 107 patients aged <45 years were randomized to interventional therapy (neurosurgery, embolization, and/or stereotactic radiotherapy) or medical management and followed for a mean (SD) period of 33.3 (19.7) months. The rate of stroke and/or death was higher in patients randomized
interventional therapy (36/116 versus 12/110, p=<.0001). The risk of stroke and/or death was non-significantly higher in patients <45 years randomized to interventional treatment (HR 2.2, 95% CI 0.9 - 5.4, p=.076). The risk of stroke and/or death was significantly higher in patients ≥45 years randomized to interventional treatment (HR 5.2, 95% CI 1.5 - 17.6, p+.008).

Conclusions Interventional treatment appeared to have a more favorable comparison to medical treatment in patients with BAVM who are aged <45 years but no benefit could be identified in the short
term follow up.

Authors/Disclosures
Omar Saeed, MD PRESENTER	Dr. Saeed has nothing to disclose.
Sindhu Sahito, MD (JFK Medical Center)	Dr. Sahito has nothing to disclose.
Mushtaq H. Qureshi, MD	No disclosure on file
Muhammad F. Suri, MD (St Cloud Hospital)	Dr. Suri 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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