Ebs avm recurrence

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  • 1. EBS PresentationDoes an AVM recur after microsurgical resectionwith a negative post operative angiogram? Nirav J. Patel 17th November, 2011 Advanced Scholar: Morgan
  • 2. Introduction and Terms• Most authors state that adult AVMs are “cured” after microsurgery, with a negative post operative angiogram. – However, this is questioned, since there are some case reports, especially in the paediatric population.• Recur: After microsurgery and negative post op angiogram, we find an AVM, either by MRI, angiogram or clinical (bleed). – Recur may be due to de novo formation, regrowth of missed AVM, regrowth from the same bed etc.• Clinical Purpose: Can we tell a patient that after AVM surgery, if the angiogram shows no AVM, that they are cured forever?
  • 3. Search strategy• P = Patients after microsurgical resection with negative postoperative angiogram.• I = follow up: angiogram, MRI, clinical• C=• O = Recurrence by imaging or clinical• Ovid Medline, Scopus
  • 4. Search terms• P= – Intracranial Arteriovenous Malformations, brain arteriovenous malformation*, intracranial angioma*; – Microsurgery, Neurosurgical Procedures, Surgical Procedures, operative, surg*, resect*, extirpat*, ex cis*• Outcome: – Recurrence, rebleed, reh*emorrhage, late he*morrhag, late bleed*, recur*
  • 5. Ovid Medline – Session 1
  • 6. Scopus
  • 7. • Scopus search terms:• "intracranial arteriovenous malformation*" or "cerebral arteriovenous malformation*" or "brain arteriovenous malformation*" or "intracranial angioma*" AND• *surg* or resect* or extirpat* or excis* AND• recurr* or rebleed* or reh*emorrhag* or "late h*emorrhag*" or "late bleed*"• LIMITS: English and Human
  • 8. • Excel Table
  • 9. Conclusion• AVMs can recur.• The incidence is not known due to limitation in databases, including follow up of all cases (surgeons may follow with imaging since most don’t recur).• 10 adults• 32 peds• The results of this search support that further studies are needed to know the incidence of recurrence and which patients need follow up imaging after resection.