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Open Access 04-05-2023 | Angiography | Original Article

Recurrence of brain arteriovenous malformations in pediatric patients: a long-term follow-up study

Authors: Elias Oulasvirta, Päivi Koroknay-Pál, Jussi Numminen, Ahmad Hafez, Rahul Raj, Behnam Rezai Jahromi, Mika Niemelä, Aki Laakso

Published in: Acta Neurochirurgica | Issue 6/2023

Abstract

Background

Previously thought to be congenital, AVMs have shown evidence of de-novo formation and continued growth, thus shifting thoughts on their pathophysiology. Pediatric AVM patients have been reported to be more prone to develop AVM recurrence after a seemingly complete cure. Therefore, we assessed the risk of AVM treated in childhood to recur in adulthood after a long-term follow-up in our own cohort.

Methods

Control DS-angiography was arranged during 2021–2022 as part of a new protocol for all AVM patients who were under 21 years of age at the time of their treatment and in whom the treatment had occurred at least five years earlier. Angiography was offered only to patients under 50 years of age at the time of the new protocol. The complete eradication of AVM after the primary treatment had been originally confirmed with DSA in every patient.

Results

A total of 42 patients participated in the late DSA control, and 41 of them were included in this analysis after excluding the patient diagnosed with HHT. The median age at the time of admission for AVM treatment was 14.6 (IQR 12–19, range 7–21 years) years. The median age at the time of the late follow-up DSA was 33.8 years (IQR 29.8–38.6, range 19.4–47.9 years). Two recurrent sporadic AVMs and one recurrent AVM in a patient with hereditary hemorrhagic telangiectasia (HHT) were detected. The recurrence rate was 4.9% for sporadic AVMs and 7.1% if HHT-AVM was included. All the recurrent AVMs had originally bled and been treated microsurgically. The patients with sporadic AVM recurrence had been smoking their whole adult lives.

Conclusions

Pediatric and adolescent patients are prone to develop recurrent AVMs, even after complete AVM obliteration verified by angiography. Therefore, imaging follow-up is recommended.

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Title: Recurrence of brain arteriovenous malformations in pediatric patients: a long-term follow-up study
Authors: Elias Oulasvirta
Päivi Koroknay-Pál
Jussi Numminen
Ahmad Hafez
Rahul Raj
Behnam Rezai Jahromi
Mika Niemelä
Aki Laakso
Publication date: 04-05-2023
Publisher: Springer Vienna
Keywords: Angiography
Brain Arteriovenous Malformation
Arteriovenous Malformation
Published in: Acta Neurochirurgica / Issue 6/2023
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-023-05612-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Recurrence of brain arteriovenous malformations in pediatric patients: a long-term follow-up study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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