Unless thoroughly treated, brain arteriovenous malformations (AVMs) pose a risk of rupture and subsequent morbidity or mortality. AVMs in children have been reported to reappear the following obliteration on occasion. This study determines the risk of AVM recurrence in children after angiographically verified demolition. Researchers employed a prospective database to detect consecutive pediatric AVMs treated at a single location. The study comprised patients who had angiographically confirmed AVM obliteration after treatment. The two-tailed Fisher exact test or the Mann-Whitney U-test were used to evaluate associations between AVM recurrence and patient or procedural characteristics. A literature search was conducted using PubMed, Scopus, Embase, and the Clarivate Web of Science with stated search criteria. Appropriate papers were included in a meta-analysis with this research cohort. With a random-effects model, rates of AVM recurrence after obliteration were pooled across studies and given with 95% confidence intervals (CIs).
Recurrence was seen in 10.4% (7/67) of juvenile AVMs treated at the authors’ center after angiographic confirmation of obliteration. Recurrent AVM patients were substantially younger than those who did not have a recurrence (p = 0.002). In the meta-analysis, the recurrence rate was 4.8% (95% CI 3.0%–6.7%), which included 1134 participants from 24 studies. AVM recurrence was 0.7% (95% CI 0%–1.6%) after radiosurgery, much lower than the 8.5% (95% CI 5.0%–12.0%) after microsurgery. In youngsters, recurrence of destroyed brain AVMs is common. In young children and after microsurgery, recurrence is more prevalent.
Reference:thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/28/6/article-p677.xml
