Long term treatment efficacy &amp; complications of hypofractionated stereotactic radiosurgery in brain arteriovenous malformations

Tam, Aurora K.Y.; Chan, David; Lim, Kevin; Poon, Darren M.C.; Kam, Michael K.M.; Cheung, Maggie; Wong, George Kwok Chu

doi:10.1016/j.jocn.2020.10.057

Cited by 4 publications

(3 citation statements)

References 25 publications

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“…Embolization can be used in selected cases for embolization cure or as an adjunct to surgery or radiosurgery, as shown in around 40% of all the embolization sessions in this study. 8,9 Characteristics of PHIL and Squid PHIL and Squid are newer non-adhesive liquid embolic agents for embolization of cerebral AVM. Squid has smaller-sized grains of tantalum powder that enhance the homogeneity in radiopacity, allow slower precipitation, and improve visibility during a longer injection time.…”

Section: Discussionmentioning

confidence: 99%

“…Embolization of cerebral AVM with liquid embolic agent PHIL and Squid is effective in achieving a satisfactory nidal obliteration rate with a complete obliteration rate of 17% and a mean nidal obliteration rate per session of 57%. Embolization can be used in selected cases for embolization cure or as an adjunct to surgery or radiosurgery, as shown in around 40% of all the embolization sessions in this study [ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

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PHIL and Squid Embolization of Cerebral Arteriovenous Malformation: A Retrospective Case Series of 23 Patients

Cheung

et al. 2022

Neurointervention

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Precipitating hydrophobic injectable liquid (PHIL; MicroVention, Aliso Viejo, CA, USA) and Squid (Balt, Irvine, CA, USA) are 2 newer liquid embolic agents used in endovascular embolization of cerebral arteriovenous malformation (AVM). This study aims to investigate and compare the effectiveness and safety profile of the 2 newer liquid embolic agents in the embolization of cerebral AVM. This is a retrospective study on all patients diagnosed with cerebral AVM undergoing endovascular embolization with liquid embolic agents PHIL and Squid admitted to the Division of Neurosurgery, Department of Surgery in Prince of Wales Hospital from January 2014 to June 2021. Twenty-three patients with cerebral AVM were treated with 34 sessions of endovascular embolization with either PHIL or Squid (17 sessions each) liquid embolic agents with a male to female ratio of 2.3:1 (male 16; female 7) and mean age of 44.6 (range, 12 to 67). The mean total nidus obliteration rate per session was 57% (range, 5% to 100%). Twenty-one patients (91.3%) received further embolization, stereotactic radiosurgery, or surgical excision after initial endovascular embolization. There were 2 morbidities (1 neurological and 1 non-neurological, 6%) and no mortalities (0%). All patients had static or improvement in modified Rankin Scale at 3 to 6 months at discharge. PHIL and Squid are effective and safe liquid embolic agents for endovascular embolization of cerebral AVM, achieving satisfactory nidal obliteration rates and patient functional outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

PHIL and Squid Embolization of Cerebral Arteriovenous Malformation: A Retrospective Case Series of 23 Patients

Cheung

et al. 2022

Neurointervention

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“…Tam et al. ( 15 ) found that the mRBAS score was an independent factor affecting the obliteration rate after hypofractionated SRS in a 5-year follow-up study. None of the AVMs with mRBAS>5.35 were obliterated.…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting Volume Reduction Velocity for Arteriovenous Malformations After Treatment With Dose-Stage Stereotactic Radiosurgery

et al. 2021

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Background and PurposeThe purpose of this study was to identify morphologic and dosimetric features associated with volume reduction velocity for arteriovenous malformation (AVM) after dose-stage stereotactic radiosurgery (DS-SRS).MethodsThirty patients with intracranial AVM were treated with DS fractionated SRS at Beijing Tiantan Hospital from 2011 to 2019. The AVM nidus was automatically segmented from DICOMRT files using the 3D Slicer software. The change in lesion volume was obtained from the decrease in the planning target volume (PTV) between the two treatment sessions. The volume reduction velocity was measured by the change in volume divided by the time interval between treatments. Fourteen morphologic features of AVM prior to treatment were extracted from the PTV using ‘Pyradiomics’ implemented in Python. Along with other dosimetric features, univariate and multivariate analyses were performed to explore predictors of the volume reduction velocity.ResultsAmong the 15 male (50.0%) and 15 female (50.0%) patients enrolled in this study, 17 patients (56.7%) initially presented with hemorrhage. The mean treatment interval between the initial and second SRS was 35.73 months. In multivariate analysis, the SurfaceVolumeRatio was the only independent factor associated with the volume reduction velocity (p=0.010, odds ratio=0.720, 95% confidence interval: 0.560–0.925). The area under the curve of this feature for predicting the volume reduction velocity after the initial treatment of DS-SRS was 0.83. (p=0.0018).ConclusionsThe morphologic features correlated well with the volume reduction velocity in patients with intracranial AVM who underwent DS-SRS treatment. The SurfaceVolumeRatio could predict the rate of volume reduction of AVMs after DS-SRS.

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Analysis of potential time saving in brain arteriovenous malformation stereotactic radiosurgery planning using a new software platform

et al. 2022

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Long term treatment efficacy & complications of hypofractionated stereotactic radiosurgery in brain arteriovenous malformations

Cited by 4 publications

References 25 publications

PHIL and Squid Embolization of Cerebral Arteriovenous Malformation: A Retrospective Case Series of 23 Patients

PHIL and Squid Embolization of Cerebral Arteriovenous Malformation: A Retrospective Case Series of 23 Patients

Factors Affecting Volume Reduction Velocity for Arteriovenous Malformations After Treatment With Dose-Stage Stereotactic Radiosurgery

Analysis of potential time saving in brain arteriovenous malformation stereotactic radiosurgery planning using a new software platform

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