Multimodal Treatment Strategy for Spetzler–Martin Grade III Arteriovenous Malformations of the Brain
The Spetzler–Martin (S–M) grading scale was developed to assess the risk of postoperative neurological complications after the surgical treatment of arteriovenous malformations (AVMs) of the brain. Treatment-associated morbidity and poor outcomes are particularly relevant to Grade III AVMs and impro...
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| Veröffentlicht in: | Neurologia medico-chirurgica 2017, Vol.57(2), pp.73-81 |
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| creator | RYU, Bikei ISHIKAWA, Tatsuya KAWAMATA, Takakazu |
| description | The Spetzler–Martin (S–M) grading scale was developed to assess the risk of postoperative neurological complications after the surgical treatment of arteriovenous malformations (AVMs) of the brain. Treatment-associated morbidity and poor outcomes are particularly relevant to Grade III AVMs and improving the safety while attaining acceptable cure rates still poses a challenge. A multimodal treatment strategy combining surgery, embolization, and radiosurgery is recommended for S–M Grade III AVMs because of the surgical risk. Grade III AVMs are the heterogeneous group that has been further divided into subgroups according to the size, the location in eloquent cortex, and the presence of deep venous drainage. The risks associated with different treatment modalities vary depending on the subgroup, and the rating scales have been further refined to predict the risk more accurately and help determine the most appropriate treatment choice. Previous results for the treatment of S–M Grade III AVMs vary widely among studies, and the treatment modalities are also different in each study. Being familiar with previous treatment results is essential for improving treatment outcomes. |
| doi_str_mv | 10.2176/nmc.ra.2016-0056 |
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Treatment-associated morbidity and poor outcomes are particularly relevant to Grade III AVMs and improving the safety while attaining acceptable cure rates still poses a challenge. A multimodal treatment strategy combining surgery, embolization, and radiosurgery is recommended for S–M Grade III AVMs because of the surgical risk. Grade III AVMs are the heterogeneous group that has been further divided into subgroups according to the size, the location in eloquent cortex, and the presence of deep venous drainage. The risks associated with different treatment modalities vary depending on the subgroup, and the rating scales have been further refined to predict the risk more accurately and help determine the most appropriate treatment choice. Previous results for the treatment of S–M Grade III AVMs vary widely among studies, and the treatment modalities are also different in each study. Being familiar with previous treatment results is essential for improving treatment outcomes.</description><identifier>ISSN: 0470-8105</identifier><identifier>EISSN: 1349-8029</identifier><identifier>DOI: 10.2176/nmc.ra.2016-0056</identifier><identifier>PMID: 27169498</identifier><language>eng</language><publisher>Japan: The Japan Neurosurgical Society</publisher><subject>arteriovenous malformations ; Combined Modality Therapy ; Embolization ; Embolization, Therapeutic ; Humans ; Intracranial Arteriovenous Malformations - therapy ; Microsurgery ; Morbidity ; multimodal treatment ; Neurological complications ; Postoperative Complications - epidemiology ; Postoperative Complications - prevention & control ; Radiosurgery ; Review ; Spetzler–Martin grading ; Surgery ; Treatment Outcome</subject><ispartof>Neurologia medico-chirurgica, 2017, Vol.57(2), pp.73-81</ispartof><rights>2017 by The Japan Neurosurgical Society</rights><rights>Copyright Japan Science and Technology Agency 2017</rights><rights>2017 The Japan Neurosurgical Society 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c775t-5569af4fed05bf53fb0a7b1650bb6c9ae0804cb08f6f4a617e32cea16b3b3cc23</citedby><cites>FETCH-LOGICAL-c775t-5569af4fed05bf53fb0a7b1650bb6c9ae0804cb08f6f4a617e32cea16b3b3cc23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5341343/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5341343/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,1877,4010,27900,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27169498$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>RYU, Bikei</creatorcontrib><creatorcontrib>ISHIKAWA, Tatsuya</creatorcontrib><creatorcontrib>KAWAMATA, Takakazu</creatorcontrib><creatorcontrib>Department of Neurosurgery</creatorcontrib><creatorcontrib>Tokyo Women's Medical University</creatorcontrib><title>Multimodal Treatment Strategy for Spetzler–Martin Grade III Arteriovenous Malformations of the Brain</title><title>Neurologia medico-chirurgica</title><addtitle>Neurol. Med. Chir.(Tokyo)</addtitle><description>The Spetzler–Martin (S–M) grading scale was developed to assess the risk of postoperative neurological complications after the surgical treatment of arteriovenous malformations (AVMs) of the brain. Treatment-associated morbidity and poor outcomes are particularly relevant to Grade III AVMs and improving the safety while attaining acceptable cure rates still poses a challenge. A multimodal treatment strategy combining surgery, embolization, and radiosurgery is recommended for S–M Grade III AVMs because of the surgical risk. Grade III AVMs are the heterogeneous group that has been further divided into subgroups according to the size, the location in eloquent cortex, and the presence of deep venous drainage. The risks associated with different treatment modalities vary depending on the subgroup, and the rating scales have been further refined to predict the risk more accurately and help determine the most appropriate treatment choice. Previous results for the treatment of S–M Grade III AVMs vary widely among studies, and the treatment modalities are also different in each study. Being familiar with previous treatment results is essential for improving treatment outcomes.</description><subject>arteriovenous malformations</subject><subject>Combined Modality Therapy</subject><subject>Embolization</subject><subject>Embolization, Therapeutic</subject><subject>Humans</subject><subject>Intracranial Arteriovenous Malformations - therapy</subject><subject>Microsurgery</subject><subject>Morbidity</subject><subject>multimodal treatment</subject><subject>Neurological complications</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - prevention & control</subject><subject>Radiosurgery</subject><subject>Review</subject><subject>Spetzler–Martin grading</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><issn>0470-8105</issn><issn>1349-8029</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUU1v1DAQjRCIrkrvnFAkLlyy-CO2kwtSqeiyUlccWs7WxJnsukrsxXEqtSf-A_-QX4LDlqVw8Pgwb97Mey_LXlOyZFTJ924wywBLRqgsCBHyWbagvKyLirD6ebYgpSJFRYk4yc7G0TaEsLIqeaVeZidMUVmXdbXIus3URzv4Fvr8JiDEAV3Mr2OAiNv7vPMhv95jfOgx_Pz-YwMhWpevArSYr9fr_DxEDNbfofPTmG-gTwMDROvdmPsujzvMPwaw7lX2ooN-xLPH_zT7evnp5uJzcfVltb44vyqMUiIWQsgaurLDloimE7xrCKiGSkGaRpoakFSkNA2pOtmVIKlCzgwClQ1vuDGMn2YfDrz7qRmwNUlMgF7vgx0g3GsPVv_bcXant_5OC14m83giePdIEPy3CceoBzsa7HtwmCRqWlXJe5HMTdC3_0Fv_RRckqcZ47VkLDmeUOSAMsGPY8DueAwles5Rpxx1AD3nqOcc08ibpyKOA39SS4DVAZC61kDvXW8d_l1vWupwCjhzqplTEZY-np6aS0VZxSitRWK6PDDdjhG2eFw152x6_H2bUJrN5emNR4DZQdDo-C9eO8xp</recordid><startdate>2017</startdate><enddate>2017</enddate><creator>RYU, Bikei</creator><creator>ISHIKAWA, Tatsuya</creator><creator>KAWAMATA, Takakazu</creator><general>The Japan Neurosurgical Society</general><general>THE JAPAN NEUROSURGICAL SOCIETY</general><general>Japan Science and Technology Agency</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>5PM</scope></search><sort><creationdate>2017</creationdate><title>Multimodal Treatment Strategy for Spetzler–Martin Grade III Arteriovenous Malformations of the Brain</title><author>RYU, Bikei ; ISHIKAWA, Tatsuya ; KAWAMATA, Takakazu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c775t-5569af4fed05bf53fb0a7b1650bb6c9ae0804cb08f6f4a617e32cea16b3b3cc23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>arteriovenous malformations</topic><topic>Combined Modality Therapy</topic><topic>Embolization</topic><topic>Embolization, Therapeutic</topic><topic>Humans</topic><topic>Intracranial Arteriovenous Malformations - therapy</topic><topic>Microsurgery</topic><topic>Morbidity</topic><topic>multimodal treatment</topic><topic>Neurological complications</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - prevention & control</topic><topic>Radiosurgery</topic><topic>Review</topic><topic>Spetzler–Martin grading</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>RYU, Bikei</creatorcontrib><creatorcontrib>ISHIKAWA, Tatsuya</creatorcontrib><creatorcontrib>KAWAMATA, Takakazu</creatorcontrib><creatorcontrib>Department of Neurosurgery</creatorcontrib><creatorcontrib>Tokyo Women's Medical University</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neurologia medico-chirurgica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>RYU, Bikei</au><au>ISHIKAWA, Tatsuya</au><au>KAWAMATA, Takakazu</au><aucorp>Department of Neurosurgery</aucorp><aucorp>Tokyo Women's Medical University</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multimodal Treatment Strategy for Spetzler–Martin Grade III Arteriovenous Malformations of the Brain</atitle><jtitle>Neurologia medico-chirurgica</jtitle><addtitle>Neurol. Med. Chir.(Tokyo)</addtitle><date>2017</date><risdate>2017</risdate><volume>57</volume><issue>2</issue><spage>73</spage><epage>81</epage><pages>73-81</pages><issn>0470-8105</issn><eissn>1349-8029</eissn><abstract>The Spetzler–Martin (S–M) grading scale was developed to assess the risk of postoperative neurological complications after the surgical treatment of arteriovenous malformations (AVMs) of the brain. Treatment-associated morbidity and poor outcomes are particularly relevant to Grade III AVMs and improving the safety while attaining acceptable cure rates still poses a challenge. A multimodal treatment strategy combining surgery, embolization, and radiosurgery is recommended for S–M Grade III AVMs because of the surgical risk. Grade III AVMs are the heterogeneous group that has been further divided into subgroups according to the size, the location in eloquent cortex, and the presence of deep venous drainage. The risks associated with different treatment modalities vary depending on the subgroup, and the rating scales have been further refined to predict the risk more accurately and help determine the most appropriate treatment choice. Previous results for the treatment of S–M Grade III AVMs vary widely among studies, and the treatment modalities are also different in each study. Being familiar with previous treatment results is essential for improving treatment outcomes.</abstract><cop>Japan</cop><pub>The Japan Neurosurgical Society</pub><pmid>27169498</pmid><doi>10.2176/nmc.ra.2016-0056</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | arteriovenous malformations Combined Modality Therapy Embolization Embolization, Therapeutic Humans Intracranial Arteriovenous Malformations - therapy Microsurgery Morbidity multimodal treatment Neurological complications Postoperative Complications - epidemiology Postoperative Complications - prevention & control Radiosurgery Review Spetzler–Martin grading Surgery Treatment Outcome |
| title | Multimodal Treatment Strategy for Spetzler–Martin Grade III Arteriovenous Malformations of the Brain |
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