Radiosurgery in treatment of cerebral arteriovenous malformation: Mid-term results of 388 cases from a single center

BACKGROUND AND OBJECTIVES: The purpose of this study is to evaluate the outcome and risks of radiosurgery for patients with arteriovenous malformations (AVM) of the brain all treated in a single center in the 3(rd) world with all its limitations. MATERIALS AND METHODS: We performed a retrospective analysis of 388 patients with AVM treated with radiosurgery during an 8-year period. Factors associated with increased chance of AVM obliteration or hemorrhages during the follow-up period were analyzed. RESULTS: Among 388 cases included in our series, 74 were Spetzler-Martin (SM) grade IV or V. Forty-four patients (11.3%) experienced post-radiosurgery hemorrhage in their follow-up period. The number of feeders (one/multiple) and deep location of the AVM did not alter the chance of bleeding (P < 0.05). Higher SM grading of the AVM was associated with increased chance of hemorrhage and decreased obliteration rate (P > 0.05) in the mid-term follow up. CONCLUSIONS: Our case series showed that radiosurgery can be considered a viable alternative in the treatment of even large AVMs which might not be considered good candidates for surgery or endovascular treatment. Further data including large size lesions are warranted to further support our findings.