European consensus conference on unruptured brain AVMs treatment (supported by EANS, ESMINT, EGKS, and SINCH)

Marco Cenzato*, Edoardo Boccardi, Ettore Beghi, Peter Vajkoczy, Istvan Szikora, Enrico Motti, Luca Regli, Andreas Raabe, Shalva Eliava, Andreas Gruber, Torstein R. Meling, Mika Niemela, Alberto Pasqualin, Andrey Golanov, Bengt Karlsson, Andras Kemeny, Roman Liscak, Bodo Lippitz, Matthias Radatz, Alessandro La Camera & 7 others René Chapot, Civan Islak, Laurent Spelle, Alberto Debernardi, Elio Agostoni, Martina Revay, Michael K. Morgan

*Corresponding author for this work

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Abstract

In December of 2016, a Consensus Conference on unruptured AVM treatment, involving 24 members of the three European societies dealing with the treatment of cerebral AVMs (EANS, ESMINT, and EGKS) was held in Milan, Italy. The panel made the following statements and general recommendations: (1) Brain arteriovenous malformation (AVM) is a complex disease associated with potentially severe natural history; (2) The results of a randomized trial (ARUBA) cannot be applied equally for all unruptured brain arteriovenous malformation (uBAVM) and for all treatment modalities; (3) Considering the multiple treatment modalities available, patients with uBAVMs should be evaluated by an interdisciplinary neurovascular team consisting of neurosurgeons, neurointerventionalists, radiosurgeons, and neurologists experienced in the diagnosis and treatment of brain AVM; (4) Balancing the risk of hemorrhage and the associated restrictions of everyday activities related to untreated unruptured AVMs against the risk of treatment, there are sufficient indications to treat unruptured AVMs grade 1 and 2 (Spetzler–Martin); (5) There may be indications for treating patients with higher grades, based on a case-to-case consensus decision of the experienced team; (6) If treatment is indicated, the primary strategy should be defined by the multidisciplinary team prior to the beginning of the treatment and should aim at complete eradication of the uBAVM; (7) After having considered the pros and cons of a randomized trial vs. a registry, the panel proposed a prospective European Multidisciplinary Registry.

Original languageEnglish
Pages (from-to)1059-1064
Number of pages6
JournalActa Neurochirurgica
Volume159
Issue number6
DOIs
Publication statusPublished - Jun 2017

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Keywords

  • unruptured brain AVM
  • arteriovenous malformation
  • Consensus Conference
  • EANS
  • EGKS
  • ESMINT
  • ARUBA

Cite this

Cenzato, M., Boccardi, E., Beghi, E., Vajkoczy, P., Szikora, I., Motti, E., ... Morgan, M. K. (2017). European consensus conference on unruptured brain AVMs treatment (supported by EANS, ESMINT, EGKS, and SINCH). Acta Neurochirurgica, 159(6), 1059-1064. https://doi.org/10.1007/s00701-017-3154-8