TY - JOUR

T1 - Algorithm for Endovascular Treatment of Patients With Spinal Arteriovenous Malformations

AU - Perfilyev, Artem M.

AU - Rzaev, Jamil A.

N1 - Перфильев А.М., Рзаев Д.А. Алгоритм эндоваскулярного лечения пациентов со спинальными артериовенозными мальформациями // Инновационная медицина Кубани. - 2023. - № 3. - С. 5-12. Публикация для корректировки.

PY - 2023

Y1 - 2023

N2 - Objective: To compare the endovascular treatment results in patients with spinal arteriovenous malformations (AVM) based on the proposed algorithm. Materials and methods: We retrospectively analyzed the endovascular treatment results in 72 patients with various types of spinal AVMs for 2014-2021. We formed 2 main groups of patients based on the developed indications for neurophysiological monitoring and provocative tests (NFM and PT): group 1 (n = 63) was treated according to the algorithm, and group 2 (n = 9) was treated before the algorithm was implemented. Group 1 was divided into subgroup 1.1 (n = 42) including patients with no indications for NFM and PT and subgroup 1.2 (n = 21) with patients indicated for NFM and PT. Subgroup 1.2 was further divided into subsubgroup 1.2A (n = 2) with patients indicated for NFM and PT yet to be informative due to severe neurological deficit and subsubgroup 1.2B (n=19) with patients that had indications for and successfully underwent NFM and PT. We compared patients between groups 1 and 2, subsubgroup 1.2B and group 2 to evaluate the effectiveness of the algorithm (radical nature of the treatment, functional status assessment, complications). Results: Radical nature of spinal AVM treatment in group 1 was 79% compared with 44% in group 2 (P=.043). There was a significant improvement in motor function in group 1 compared with group 2 in each follow-up period (Р≤ .007). Comparison of subsubgroup 1.2B and group 2 showed no significant differences (P=.05). The treatment led to complications in 5 patients (7% of the total number of patients with spinal AVMs): 4 patients in group 2 and 1 patient in subsubgroup 1.2B. The effectiveness of the developed criteria was indirectly confirmed by difference in complications number between subsubgroup 1.2B and group 2 (P=.001). Conclusions: Group 1 showed better treatment results, significant clinical improvement, high radical nature of treatment, and a low percentage of complications compared with group 2. The proposed algorithm proved effective for main tasks of endovascular treatment of spinal AVMs.

AB - Objective: To compare the endovascular treatment results in patients with spinal arteriovenous malformations (AVM) based on the proposed algorithm. Materials and methods: We retrospectively analyzed the endovascular treatment results in 72 patients with various types of spinal AVMs for 2014-2021. We formed 2 main groups of patients based on the developed indications for neurophysiological monitoring and provocative tests (NFM and PT): group 1 (n = 63) was treated according to the algorithm, and group 2 (n = 9) was treated before the algorithm was implemented. Group 1 was divided into subgroup 1.1 (n = 42) including patients with no indications for NFM and PT and subgroup 1.2 (n = 21) with patients indicated for NFM and PT. Subgroup 1.2 was further divided into subsubgroup 1.2A (n = 2) with patients indicated for NFM and PT yet to be informative due to severe neurological deficit and subsubgroup 1.2B (n=19) with patients that had indications for and successfully underwent NFM and PT. We compared patients between groups 1 and 2, subsubgroup 1.2B and group 2 to evaluate the effectiveness of the algorithm (radical nature of the treatment, functional status assessment, complications). Results: Radical nature of spinal AVM treatment in group 1 was 79% compared with 44% in group 2 (P=.043). There was a significant improvement in motor function in group 1 compared with group 2 in each follow-up period (Р≤ .007). Comparison of subsubgroup 1.2B and group 2 showed no significant differences (P=.05). The treatment led to complications in 5 patients (7% of the total number of patients with spinal AVMs): 4 patients in group 2 and 1 patient in subsubgroup 1.2B. The effectiveness of the developed criteria was indirectly confirmed by difference in complications number between subsubgroup 1.2B and group 2 (P=.001). Conclusions: Group 1 showed better treatment results, significant clinical improvement, high radical nature of treatment, and a low percentage of complications compared with group 2. The proposed algorithm proved effective for main tasks of endovascular treatment of spinal AVMs.

KW - algorithm for spinal arteriovenous malformations treatment

KW - endovascular treatment

KW - neurophysiological monitoring and provocative tests

KW - spinal arteriovenous malformations

UR - https://www.scopus.com/record/display.uri?eid=2-s2.0-85170656851&origin=inward&txGid=410465928cdcfab9e1b01b7d3101dd23

UR - https://elibrary.ru/item.asp?id=54303303

UR - https://www.mendeley.com/catalogue/0fcef183-839a-3588-947a-42ca30c9a819/

U2 - 10.35401/2541-9897-2023-26-3-5-12

DO - 10.35401/2541-9897-2023-26-3-5-12

M3 - Article

VL - 8

SP - 5

EP - 12

JO - Инновационная медицина Кубани

JF - Инновационная медицина Кубани

SN - 2500-0268

IS - 3

M1 - 1

ER -