Quantitative evaluation of the subsequent hemorrhage with arteriography-derived hemodynamic features in patients with untreated cerebral arteriovenous malformation
BackgroundPatients with untreated cerebral arteriovenous malformations (AVMs) are at risk of intracerebral hemorrhage. However, treatment to prevent AVM hemorrhage carries risks.ObjectiveThis study aimed to analyze the AVM nidus-related hemodynamic features and identify the risk factors for subseque...
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| Format: | Article |
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Frontiers Media S.A.
2023-08-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1174245/full |
| _version_ | 1828717836966559744 |
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| author | Haoyu Zhu Lian Liu Yuzhou Chang Yuqi Song Shikai Liang Chao Ma Longhui Zhang Fei Liang Chuhan Jiang Yupeng Zhang |
| author_facet | Haoyu Zhu Lian Liu Yuzhou Chang Yuqi Song Shikai Liang Chao Ma Longhui Zhang Fei Liang Chuhan Jiang Yupeng Zhang |
| author_sort | Haoyu Zhu |
| collection | DOAJ |
| description | BackgroundPatients with untreated cerebral arteriovenous malformations (AVMs) are at risk of intracerebral hemorrhage. However, treatment to prevent AVM hemorrhage carries risks.ObjectiveThis study aimed to analyze the AVM nidus-related hemodynamic features and identify the risk factors for subsequent hemorrhage.MethodsWe retrospectively identified patients with untreated AVMs who were assessed at our institution between March 2010 and March 2021. Patients with ≥6 months of treatment-free and hemorrhage-free follow-up after diagnosed by digital subtraction angiography were included in subsequent examinations. The hemodynamic features were extracted from five contrast flow-related parameter maps. The Kaplan-Meier analyses and Cox proportional hazards regression models were used to find the potential risk factors for subsequent hemorrhage.ResultsOverall, 104 patients with a mean follow-up duration of 3.37 years (median, 2.42 years; range, 6–117 months) were included in study, and the annual risk of rupture was 3.7%. Previous rupture (hazard ratio [HR], 4.89; 95% confidence interval [CI], 1.16–20.72), deep AVM location (HR, 4.02; 95% CI, 1.01–15.99), higher cerebral blood volume (HR, 3.35; 95% CI, 1.15–9.74) in the nidus, and higher stasis index (HR, 1.54; 95% CI, 1.06–2.24) in the nidus were associated with subsequent hemorrhage in untreated AVMs.ConclusionHigher cerebral blood volume and stasis index in the nidus suggest increased blood inflow and stagnant blood drainage. The combination of these factors may cause subsequent hemorrhage of AVMs. |
| first_indexed | 2024-03-12T14:34:13Z |
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| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-12T14:34:13Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj.art-61e7f2589599418385de7223cc5ac0bb2023-08-17T10:25:35ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-08-011410.3389/fneur.2023.11742451174245Quantitative evaluation of the subsequent hemorrhage with arteriography-derived hemodynamic features in patients with untreated cerebral arteriovenous malformationHaoyu Zhu0Lian Liu1Yuzhou Chang2Yuqi Song3Shikai Liang4Chao Ma5Longhui Zhang6Fei Liang7Chuhan Jiang8Yupeng Zhang9Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, ChinaDepartment of Neurosurgery, School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, ChinaDepartment of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, ChinaDepartment of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaBackgroundPatients with untreated cerebral arteriovenous malformations (AVMs) are at risk of intracerebral hemorrhage. However, treatment to prevent AVM hemorrhage carries risks.ObjectiveThis study aimed to analyze the AVM nidus-related hemodynamic features and identify the risk factors for subsequent hemorrhage.MethodsWe retrospectively identified patients with untreated AVMs who were assessed at our institution between March 2010 and March 2021. Patients with ≥6 months of treatment-free and hemorrhage-free follow-up after diagnosed by digital subtraction angiography were included in subsequent examinations. The hemodynamic features were extracted from five contrast flow-related parameter maps. The Kaplan-Meier analyses and Cox proportional hazards regression models were used to find the potential risk factors for subsequent hemorrhage.ResultsOverall, 104 patients with a mean follow-up duration of 3.37 years (median, 2.42 years; range, 6–117 months) were included in study, and the annual risk of rupture was 3.7%. Previous rupture (hazard ratio [HR], 4.89; 95% confidence interval [CI], 1.16–20.72), deep AVM location (HR, 4.02; 95% CI, 1.01–15.99), higher cerebral blood volume (HR, 3.35; 95% CI, 1.15–9.74) in the nidus, and higher stasis index (HR, 1.54; 95% CI, 1.06–2.24) in the nidus were associated with subsequent hemorrhage in untreated AVMs.ConclusionHigher cerebral blood volume and stasis index in the nidus suggest increased blood inflow and stagnant blood drainage. The combination of these factors may cause subsequent hemorrhage of AVMs.https://www.frontiersin.org/articles/10.3389/fneur.2023.1174245/fullarteriovenous malformationhemodynamicssubsequent hemorrhagetime density curveangiographic parametric imaging |
| spellingShingle | Haoyu Zhu Lian Liu Yuzhou Chang Yuqi Song Shikai Liang Chao Ma Longhui Zhang Fei Liang Chuhan Jiang Yupeng Zhang Quantitative evaluation of the subsequent hemorrhage with arteriography-derived hemodynamic features in patients with untreated cerebral arteriovenous malformation Frontiers in Neurology arteriovenous malformation hemodynamics subsequent hemorrhage time density curve angiographic parametric imaging |
| title | Quantitative evaluation of the subsequent hemorrhage with arteriography-derived hemodynamic features in patients with untreated cerebral arteriovenous malformation |
| title_full | Quantitative evaluation of the subsequent hemorrhage with arteriography-derived hemodynamic features in patients with untreated cerebral arteriovenous malformation |
| title_fullStr | Quantitative evaluation of the subsequent hemorrhage with arteriography-derived hemodynamic features in patients with untreated cerebral arteriovenous malformation |
| title_full_unstemmed | Quantitative evaluation of the subsequent hemorrhage with arteriography-derived hemodynamic features in patients with untreated cerebral arteriovenous malformation |
| title_short | Quantitative evaluation of the subsequent hemorrhage with arteriography-derived hemodynamic features in patients with untreated cerebral arteriovenous malformation |
| title_sort | quantitative evaluation of the subsequent hemorrhage with arteriography derived hemodynamic features in patients with untreated cerebral arteriovenous malformation |
| topic | arteriovenous malformation hemodynamics subsequent hemorrhage time density curve angiographic parametric imaging |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1174245/full |
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