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Unruptured brain arteriovenous malformations : primary ONYX embolization in ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations)-eligible patients

(2017) STROKE. 48(12). p.3393-3396
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Organization
Abstract
Background and Purpose: In light of evidence from ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations), neurovascular specialists had to reconsider deliberate treatment of unruptured brain arteriovenous malformations (uBAVMs). Our objective was to determine the outcomes of uBAVM treated with primary embolization using ethylene vinyl alcohol (ONYX). Methods: Patients with uBAVM who met the inclusion criteria of ARUBA and were treated with primary Onyx embolization were assigned to this retrospective study. The primary outcome was the modified Rankin Scale score. Secondary outcomes were stroke or death because of uBAVM or intervention and uBAVM obliteration. Results: Sixty-one patients (mean age, 38 years) were included. The median observation period was 60 months. Patients were treated by embolization alone (41.0%), embolization and radiosurgery (57.4%), or embolization and excision (1.6%). Occlusion was achieved in 44 of 57 patients with completed treatment (77.2%). Forty-seven patients (77.1%) had no clinical impairment at the end of observation (modified Rankin Scale score of <2). Twelve patients (19.7%) reached the outcome of stroke or death because of uBAVM or intervention. Treatment-related mortality was 6.6% (4 patients). Conclusions: In uBAVM, Onyx embolization alone or combined with stereotactic radiosurgery achieves a high occlusion rate. Morbidity remains a challenge, even if it seems lower than in the ARUBA trial.
Keywords
MULTICENTER, RADIOSURGERY, METAANALYSIS, arteriovenous malformations, brain, endovascular embolization, ethylene, radiosurgery

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MLA
Singfer, Uri, et al. “Unruptured Brain Arteriovenous Malformations : Primary ONYX Embolization in ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations)-Eligible Patients.” STROKE, vol. 48, no. 12, 2017, pp. 3393–96, doi:10.1161/STROKEAHA.117.018605.
APA
Singfer, U., Hemelsoet, D., Vanlangenhove, P., Martens, F., Verbeke, L., Van Roost, D., & Defreyne, L. (2017). Unruptured brain arteriovenous malformations : primary ONYX embolization in ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations)-eligible patients. STROKE, 48(12), 3393–3396. https://doi.org/10.1161/STROKEAHA.117.018605
Chicago author-date
Singfer, Uri, Dimitri Hemelsoet, Peter Vanlangenhove, Frederic Martens, Luc Verbeke, Dirk Van Roost, and Luc Defreyne. 2017. “Unruptured Brain Arteriovenous Malformations : Primary ONYX Embolization in ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations)-Eligible Patients.” STROKE 48 (12): 3393–96. https://doi.org/10.1161/STROKEAHA.117.018605.
Chicago author-date (all authors)
Singfer, Uri, Dimitri Hemelsoet, Peter Vanlangenhove, Frederic Martens, Luc Verbeke, Dirk Van Roost, and Luc Defreyne. 2017. “Unruptured Brain Arteriovenous Malformations : Primary ONYX Embolization in ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations)-Eligible Patients.” STROKE 48 (12): 3393–3396. doi:10.1161/STROKEAHA.117.018605.
Vancouver
1.
Singfer U, Hemelsoet D, Vanlangenhove P, Martens F, Verbeke L, Van Roost D, et al. Unruptured brain arteriovenous malformations : primary ONYX embolization in ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations)-eligible patients. STROKE. 2017;48(12):3393–6.
IEEE
[1]
U. Singfer et al., “Unruptured brain arteriovenous malformations : primary ONYX embolization in ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations)-eligible patients,” STROKE, vol. 48, no. 12, pp. 3393–3396, 2017.
@article{8559608,
  abstract     = {{Background and Purpose: In light of evidence from ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations), neurovascular specialists had to reconsider deliberate treatment of unruptured brain arteriovenous malformations (uBAVMs). Our objective was to determine the outcomes of uBAVM treated with primary embolization using ethylene vinyl alcohol (ONYX). 
Methods: Patients with uBAVM who met the inclusion criteria of ARUBA and were treated with primary Onyx embolization were assigned to this retrospective study. The primary outcome was the modified Rankin Scale score. Secondary outcomes were stroke or death because of uBAVM or intervention and uBAVM obliteration. 
Results: Sixty-one patients (mean age, 38 years) were included. The median observation period was 60 months. Patients were treated by embolization alone (41.0%), embolization and radiosurgery (57.4%), or embolization and excision (1.6%). Occlusion was achieved in 44 of 57 patients with completed treatment (77.2%). Forty-seven patients (77.1%) had no clinical impairment at the end of observation (modified Rankin Scale score of <2). Twelve patients (19.7%) reached the outcome of stroke or death because of uBAVM or intervention. Treatment-related mortality was 6.6% (4 patients). 
Conclusions: In uBAVM, Onyx embolization alone or combined with stereotactic radiosurgery achieves a high occlusion rate. Morbidity remains a challenge, even if it seems lower than in the ARUBA trial.}},
  author       = {{Singfer, Uri and Hemelsoet, Dimitri and Vanlangenhove, Peter and Martens, Frederic and Verbeke, Luc and Van Roost, Dirk and Defreyne, Luc}},
  issn         = {{0039-2499}},
  journal      = {{STROKE}},
  keywords     = {{MULTICENTER,RADIOSURGERY,METAANALYSIS,arteriovenous malformations,brain,endovascular embolization,ethylene,radiosurgery}},
  language     = {{eng}},
  number       = {{12}},
  pages        = {{3393--3396}},
  title        = {{Unruptured brain arteriovenous malformations : primary ONYX embolization in ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations)-eligible patients}},
  url          = {{http://doi.org/10.1161/STROKEAHA.117.018605}},
  volume       = {{48}},
  year         = {{2017}},
}

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