Shi Wujie,Zhang Wenbo,Zhang Peiliang,et al.Efficacies and outcomes of endovascular embolization plus microsurgery for brain arteriovenous malformations in children[J].Journal of Clinical Pediatric Surgery,2025,(02):120-124.[doi:10.3760/cma.j.cn101785-202410068-004]
Efficacies and outcomes of endovascular embolization plus microsurgery for brain arteriovenous malformations in children
- Keywords:
- Cerebral Arteriovenous Malformations; Microsurgery; Endovascular Procedures; Embolism; Treatment Outcome; Comparative Study
- Abstract:
- Objective Bleeding from rupture of cerebral arteriovenous malformations (cAVM) has been the most common cause of intracranial hemorrhage in children.The therapeutic goals should be preventing rebleeding and improving quality-of-life.The objective of this study was to examine the differences in surgical approaches for pediatric cAVMs. Methods From June 2022 to June 2024,retrospective analysis was performed for the relevant clinical data from 29 cAVM children undergoing endovascular embolization plus microsurgery.The relevant clinical data of blood loss volume,microscopic procedure time,hospitalization stay and outcomes were compared between two procedures.And patient outcomes were assessed by modified Rankin scale (mRS) at the time of discharge. Results The clinical grades were Ⅰ-Ⅲ (n=25) and Ⅳ (n=4).And they were assigned to undergo interventional embolization plus microsurgery (n=10) and operation alone (n=19).Volume of blood loss was (107.0±27.1) vs. (174.7±99.4) ml and the difference was statistically significant (t=2.780,P=0.011); microscopic operative duration [72.0(63.0,120.0) vs. 140.0(102.0,160.0) min],Z=2.202,P=0.029]; hospitalization stay [11.0(10.0,14.0) vs.16.0(13.000,23.0),Z=2.501,P=0.013].The prognosis-related factors were admission mRS score (χ2=20.913,P<0.001) and Spetzler-Martin score (χ2=8.784,P=0.032). Conclusions For pediatric cAVM,endovascular embolization plus microsurgery is associated with shorter hospitalization stay,microscopic operative duration and less blood loss than surgery alone.
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Memo
收稿日期:2024-10-30。
通讯作者:沈志鹏,Email:shenzp@zju.edu.cn