Contemporary management of brain arteriovenous malformations in mainland China: a web-based nationwide questionnaire sur
- PDF / 1,419,364 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 54 Downloads / 183 Views
(2020) 6:26
中华医学会神经外科学分会 CHINESE MEDICAL ASSOCIATION
CHINESE NEUROSURGICAL SOCIETY
RESEARCH
Open Access
Contemporary management of brain arteriovenous malformations in mainland China: a web-based nationwide questionnaire survey Yu Chen1, Xiangyu Meng2, Li Ma1, Yang Zhao3, Ye Gu1, Hengwei Jin2, Dezhi Gao4, Youxiang Li2, Shibin Sun4, Ali Liu4, Yuanli Zhao1, Xiaolin Chen1* and Shuo Wang1*
Abstract Background: In the benefit of the large population and rapid economic growth, the interventional techniques and equipment for brain arteriovenous malformations (bAVMs) in mainland China have been rapidly improved. Chinese neurosurgical cerebrovascular physicians have accumulated rich experience and made pioneering explorations. This study aims to summarize the experience and treatment progress of bAVMs in mainland China. Methods: We performed a web-based nationwide questionnaire survey among 67 tertiary neurosurgical institutions that had acknowledged treating bAVMs in the primary survey. Our questionnaire included clinical characteristics, radiological findings, intervention indications/contraindications, intervention timing, and intraoperative management of different treatment modalities. Results: A total of 63 participants from 49 (73.1%) tertiary neurosurgical institutions responded to our questionnaire. Forty-two (66.7%) were neurosurgeons, 13 (20.6%) were neurointerventionists, and 8 (12.7%) were radiosurgeons. Approximately 3500 to 4000 cases of bAVMs were treated annually in these 49 departments. All participants agreed that the conclusions of ARUBA are debatable. Flow-related aneurysms, deep venous drainage, and arteriovenous fistula were considered as common hemorrhagic risk factors. Unruptured SM IV-V bAVMs, giant bAVMs, pediatric bAVMs, elderly bAVMs, and eloquent bAVMs were not absolute contraindications to intervention. Maximum lesion occlusion and minimal functional impairment were the principles of intervention management. Most of the neurosurgeons and neurointerventionists recommended early intervention (< 30 days) for ruptured bAVMs, and the radiosurgeons suggested intervention in the chronic phase or recovery phase (P < 0.01) and preferably 3 months after bleeding. Multi-modality strategies were thought effective for complex bAVMs, and more exploration of individualized intraoperative management was necessary. (Continued on next page)
* Correspondence: [email protected]; [email protected] 1 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in thi
Data Loading...
