Radiosurgical irradiation of patients with cerebral AVM on the Gamma Knife

Mariashev S.A.; Golanov A.V.; Konovalov A.N.; Yakovlev S.B.; Il'ialov S.R.; Éliava Sh.Sh.; Pronin I.N.; Kostiuchenko V.V.; Iakhina M.V.; Gorlachev G.E.

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Abstract:

Arterio-venous malformation (AVM) of the brain are congenital malformations of cerebral vessels in the embryonic period. Standards in AVM treatment is currently applying the endovascular technique, microneurosurgical removal and stereotactic radiation. Materials and methods. In the period from 2005 to 2011, in 139 patients with arteriovenous malformations of the brain were treated using "Gamma Knife". 89 (64%) of 139 patients suffered bleeding in anamnesis. Paroxysmal symptoms of varying severity dominated in the clinical picture of 35 (27%) patients. Previous microsurgical resection was performed in 10 patients. 28 patients experienced a partial embolization of vascular malformations before radiosurgery. A boundary value radiation dose ranged from 18 to 28 Gy (mean dose 20 Gy), day dose was in the range of 40-80% (average 50% isodose). Maximum dose ranged between 18-60 Gy (mean dose of 38 Gy.). Results. Control angiography or spiral CT screening angiography was performed in all 85 patients who were treated with follow-up data for more than two years, showed that total obliteration occurred in 75% of cases. Frequency of symptomatic radiation reactions was less than 5%. After two years or more after treatment, complete obliteration was observed in 74% of patients. Conclusions. Higher frequency of AVM obliteration was seen with up to 2 cc. and the irradiation dose of at least 24 Gy.

Keywords:

arterio-venous malformations

radiosurgery

obliteration

radiation reaction

Authors:

Mariashev S.A.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Golanov A.V.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

ORCID: 0000-0002-0976-4547

Konovalov A.N.

Burdenko Neurosurgical Institute, Moscow, Russian Federation

SPIN RSCI: 1462-1783
Scopus AuthorID: 57220527356
ORCID: 0000-0002-5048-0298

Yakovlev S.B.

Burdenko’ National medical research center of neurosurgery, Moscow, Russia

ORCID: 0000-0002-0798-2604

Il'ialov S.R.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Éliava Sh.Sh.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Pronin I.N.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Kostiuchenko V.V.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Iakhina M.V.

OAO "Delovoĭ tsentr neĭrokhirurgii", Moskva

Gorlachev G.E.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

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