Radio-clinical grading system for transarterial AVM embolization: Tsinghua AVM grading system - 25/10/21

Doi : 10.1016/j.neuri.2021.100021

Huachen Zhang ^a, Shikai Liang ^a, Xianli Lv ^a,^b,^{^⁎}
^a Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
^b Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Litang Road 168, 102218, Beijing, China

^⁎Corresponding author at: Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Litang Road 168, 102218, Beijing, China.Department of NeurosurgeryBeijing Tsinghua Changgung HospitalSchool of Clinical MedicineTsinghua UniversityLitang Road 168Beijing102218China

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Abstract

Background

The AVM neuroendovascular grade and the Buffalo score have been proposed to specifically predict the risk of clinical complications associated with embolization.

Objective

To develop and validate a new radio-clinical grading system that helps to determine which patient should be treated by transarterial embolization.

Methods

The proposed radio-clinical grading system was retrospectively applied to 170 consecutive AVM cases embolized transarterially between 2015 and 2018. The scoring system was based on data published before.

Results

Among 170 AVMs, 117 AVMs were embolized transarterially, complete occlusion was obtained in 71 (60.7%) cases. Three (2.6%) feeding artery perforation complications were encountered in 3 cases without causing any neurological deficits. The AVM grading system can be used to evaluate patient selection and results of endovascular embolization (p < 0.001). Patients with an AVM grade higher than 3 can be treated endovascularly compared to patients with an AVM grade 2 or lower.

Conclusion

The radio-clinical grading system could be used to determine which patient should be treated by transarterial embolization. Further testing of this scheme for complication or cure rate using prospective methodology is still required.

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Keywords : Brain, Arteriovenous malformation, Grading system, Endovascular embolization