Predicting Factors of the Outcome of Cerebral AVMs Treated with Endovascular Embolization Followed by Gamma Knife Radiosurgery

Document Type : Original Article


The Department of Neurosurgery, Faculty of Medicne, Benha University Hospital1,4, The International Medical Centre (IMC) Cairo2, Department of Intervention Radiology, Faculty of Medicine, Ain Shams University3


Abstract Background: Complete AVM obliteration could be achieved through microsurgery, endovascular techniques, or Radiosurgery (Focused Radiation), in single or combined mannar. Each treatment option has associated risks and benefits. Aim of Study: This clinical study presents a prospective study of cerebral AVMs treated with endovascular embolization followed with gamma knife radiosurgery. We analyzed the clinical and angioarchitectural outcomes as well as the com-plications. Finally we tried to find out the predicting factors for the success of this combined modality. Patients and Methods: Thirty nine patients with cerebral AVMs were treated endovascular embolization followed with gamma knife radiosurgery at The International Medical Centre in Cairo and studied analytically at THE Benha University Hospital from the beginning of January 2016 to the end of December 2021. Results: Factors that may predict the outcome clinically are: - Age. - Pre interventional mRs. - Nidal configuration. - Spetzler-Martin grade. - AVM size. Factors that may predict the outcome Radiologically are: - AVM size. - Nidal configuration. - Spetzler-Martin grade. Conclusions: Endovascular embolization followed by stereotactic radiosurgery is considered a feasible management modality for most cases of grade III and Grade IV lesions with satisfactory rates of nidal obliteration.