Predictors of angiographic occlusion after embolization of intracranial arteriovenous malformations with curative intent

Abstract

Background: Endovascular embolization is a potential alternative to open surgery for treating intracranial arteriovenous malformations (AVMs). To our knowledge, predictors of occlusion after curative embolization of AVMs remain limited in literature. Our study aims to identify predictors of radiographic occlusion after embolization of AVMs with curative intent. Methods: This was a retrospective study of patients who underwent embolization of AVMs with curative intent at a single institution between 2007 and 2022. The primary outcome of cure was defined as radiographic occlusion of the AVM on follow-up. Univariate and multivariate analyses were performed with a P value <0.05 denoting statistical significance. Results: Sixty-six patients underwent embolization of an AVM with curative intent. The median (interquartile range (IQR)) age of the cohort was 53 (36–62), and 48.5% were male. 65.2% (n = 43) patients presented with hemorrhage. 59.1% (n = 39) of the cohort achieved cure on follow-up. Median (IQR) volume of AVM (mm3)and maximum pedicle size (mm) were significantly higher in patients who were not cured on follow-up compared to those who were cured: 14055.12 (2431.71–31235.60) and 1.9 (1.3–2.5) versus 3888 (2063–12518) and 1.3 (1.1–1.6), respectively. On multivariate regression, maximum pedicle size was associated with lower odds of cure (OR: 0.24, 95% CI: 0.07–0.82, P = 0.023). Conclusions: Our study identified maximum pedicle size to be the only significant factor associated with lower odds of radiographic occlusion after curative embolization of AVMs. Further multicenter studies are required to validate these findings.