Analysis of X-knife and surgery in treatment of arteriovenous malformation of brain

被引:5
作者
Patel, Pooja Nandwani [1 ]
Vyas, Rakesh K. [1 ]
Bhavsar, Devang C. [1 ]
Suryanarayan, U. K. [1 ]
Pelagade, Satish [1 ]
Patel, Dipak [2 ]
机构
[1] Gujarat Canc Res Inst, Dept Radiat Oncol, Ahmadabad, Gujarat, India
[2] Gujarat Canc Res Inst, Dept Neurosurg, Ahmadabad, Gujarat, India
关键词
X-; knife; surgery; arteriovenous malformation;
D O I
10.4103/0973-1482.44287
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: The goal of treatment in arteriovenous malformation (AVM) is total obliteration of the AVM, restoration of normal cerebral function, and preservation of life and neurological function. Aim: To analyze the results of X-knife and surgery for AVM of the brain. The endpoints for success or failure were as follows: success was defined as angiographic obliteration and failure as residual lesion, requiring retreatment, or death due to hemorrhage from the AVM. Materials and Methods: From May 2002 to May 2007, 54 patients were enrolled for this study. Grade I AVM was seen in 9, grade II in 43, grade III in 26, grade IV in 9, and grade V in 13. Thirty-eight patients were treated by microsurgical resection out of which Grade I was seen in 5 patients, Grade II was seen in 17 patients, Grade III was seen in 9 patients and Grade V was seen in 7 patients. Rest of the sixteen patients were treated by linear accelerator radiosurgery out of which Grade II was seen in 6 patients, Grade III was seen in 5 patients and Grade IV was seen in 5 patients. The follow up was in range of 3-63 months. In follow up, digital subtraction angiography/ magnetic resonance angiography (DSA/MRA) was performed 3 months after surgery and 1 year and 2 years after stereotactic radiosurgery (SRS). Results: Among the patients treated with X-knife, 12/16 (75) had proven angiographic obliteration. Complications were seen in 4/16 (25) patients. Among the patients treated with microsurgical resection, 23/38 (61) had proven angiographic obliteration. Complications (both intraoperative and postoperative) were seen in 19/38 (50) patients. Conclusions: Sixty-one percent of patients were candidates for surgical resection. X-knife is a good modality of treatment for a low-grade AVM situated in eloquent areas of the brain and also for high-grade AVMs, when the surgical risk and morbidity is high.
引用
收藏
页码:169 / 172
页数:4
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