Abstract TMP115: Overall Characteristics And Treatment Outcome Of Arteriovenous Malformation Treated With Gamma Knife Radiosurgery: Comparative Study About The Time Dependent Changing Patterns Based On 20 Years Experiences In Single Center.
Objective: The purpose of our study was suggesting of the concepts for postradiosurgery bleeding and total obliteration that could be assisted in the future treatment of AVM by analysis of outcome AVM during last 20 years.
Material and Method: Total 1050 AVM patients treated with Gamma Knife radiosurgery between May 1990 and December 2010 were included in our study. Gamma Knife radiosurgery of AVMs were divided into two treatment periods (early 1990-2000 period and advanced 2001-2010 period) for systematic review. Retrospective analysis was performed about AVM characteristics and treatment outcome for all AVM patients of each treatment periods. We evaluated the changing pattern of AVMs and the causes of this changing pattern by comparing the two treatment periods statistically.
Result: The 617 AVM patients in advanced periods (2001~2010) represented more complex nidus as like the following: higher rate of diffuse type (12% vs 7.6%), multiple feeder (39% vs 25%), drain vein (40% vs 36%) and deep vein (43% vs 16%), but less mean radiosurgery volume (2,379mm3 vs 4,438mm3) and lower rate of initial bleeding (49% vs 69%) than 433 AVM patients in early treatment period relatively. In addition, AVM in advanced period showed higher rate of fractionation, repeat treatment and preradiosurgery embolization, but showed less radiosurgery mean marginal dose, lower rate of mortality and complication, rebleeding (6.3% vs 9.5%) and total obliteration than that of early period. Risk factor associated with initial bleeding was only periventricle location (OR:4.2,8.7) that was common included in two treatment periods statistically. On the other hand, risk factors associated with postradiosurgery bleeding were multiple feeders (OR:2.6) and diffuse type (OR:5.2) independently.
Conclusion: In summary, we present that the effects of radiosurgery in AVM patients have been increased in prevention aspect of rebleeding, mortality and complication due to fractionation and preradiosurgery embolization, but have been a little decreased in aspect of total obliteration rate due to increasing more complex nidus with diffuse type, deep location, multiple feeder and multiple drain vein based on 20 years experiences in our center.
- © 2012 by American Heart Association, Inc.