Association between draining vein diameters and intracranial arteriovenous malformation hemorrhage: a multicentric retro
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INTERVENTIONAL NEURORADIOLOGY
Association between draining vein diameters and intracranial arteriovenous malformation hemorrhage: a multicentric retrospective study Luís Henrique de Castro-Afonso 1 & José Ricardo Vanzim 2 & Felipe Padovani Trivelato 3 & Marco Tulio Rezende 3 & Alexandre Cordeiro Ulhôa 3 & Salomão Faroj Chodraui-Filho 1 & Luiz Gustavo de Abreu Mattos 4 & Charbel Mounayer 4 & Guilherme Seizem Nakiri 1 & Benedicto Oscar Colli 5 & Daniel Giansante Abud 1 & IntraCranial Arteriovenous RUpture riSk Study (ICARUSS) investigators Received: 19 March 2020 / Accepted: 22 June 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Intracranial arteriovenous malformations (AVMs) cause hemorrhage, and the role of draining vein diameters in rupture risk is controversial. The aims of the present study were to investigate the variables related with intracranial AVM rupture and to examine the association of draining vein diameters and AVM hemorrhage. Methods Two hundred three patients were included in this study, of which 117 (57%) had unruptured AVMs, and 86 (43%) had ruptured AVMs. Results In an adjusted (multivariate) analysis, the variables significantly associated with AVM hemorrhagic presentation were age (OR per year increase 0.97, 95%CI 0.95–0.99, p = 0.007), a deep nidus compared with superficial nidus (OR 3.21, 95%CI 1.13–9.06, p = 0.028), the nidus diameter (OR per each mm increase 0.95, 95%CI 0.92–0.97, p < 0.001), a single draining vein compared with multiple draining veins (OR 2.14, 95%CI 1.02–4.50, p = 0.044), the draining vein diameter (OR per mm increase 1.52, 95%CI 1.26–1.83, p < 0.001), and a draining vein diameter ≥ 5 mm compared with < 5 mm (OR 5.80, 95%CI 2.70–12.47, p < 0.001). Conclusion In this study, after adjusted analysis, the variables associated with intracranial AVM hemorrhagic presentation were a young age, a small nidus diameter, a deeply located nidus, a single draining vein, and large draining vein diameters. A draining vein diameter cutoff ≥ 5 mm was positively associated with the risk of AVM rupture. A large and prospective study is now necessary to confirm if draining vein diameter is a risk factor for AVM hemorrhage. Keywords Intracranial arteriovenous malformation . Brain arteriovenous malformation . Hemorrhage . Bleeding . Rupture
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00234-020-02484-y) contains supplementary material, which is available to authorized users. * Luís Henrique de Castro-Afonso [email protected] 1
2
Division of Interventional Neuroradiology, Medical School of Ribeirão Preto, University of São Paulo, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP 14048-090, Brazil Division of Interventional Neuroradiology, Hospital das Clínicas de Passo Fundo, Passo Fundo, RS, Brazil
3
Division of Interventional Neuroradiology, Instituto neurovascular, Felício Rocho hospital, Mater Dei hospital, University of Minas gerais, Belo Horizonte, Brazil
4
Department of Inte
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