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The primary outcomes were long\u2010term neurofunctional outcomes and hemorrhagic stroke and death. In addition to the comparisons among CM, MS, and E\u2009+\u2009MS, E\u2009+\u2009MS was divided into single\u2010staged hybrid and multi\u2010staged E\u2009+\u2009MS for further analysis. Stabilized inverse probability of treatment weighting using propensity scores was applied to control for confounders by treatment indication across the three groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 3758 consecutive AVMs admitted, 718 patients were included finally (266 CM, 364 MS, and 88 E\u2009+\u2009MS). The median follow\u2010up duration was 5.4\u2009years. Compared with CM, interventions (MS and E\u2009+\u2009MS) were associated with neurological deterioration. MS could lower the risk of hemorrhagic stroke and death. Multi\u2010staged E\u2009+\u2009MS was associated with neurological deterioration and higher hemorrhagic risks compared with MS, but the hybrid E\u2009+\u2009MS operation significantly reduced the hemorrhage risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this study, unruptured AVMs receiving CM would expect better neurofunctional outcomes but bear higher risks of hemorrhage than MS or E\u2009+\u2009MS. The single\u2010staged hybrid E\u2009+\u2009MS might be promising in reducing inter\u2010procedural and subsequent hemorrhage.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cns.14533","type":"journal-article","created":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T23:41:07Z","timestamp":1700782867000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparison of conservative management, microsurgery only, and microsurgery with preoperative embolization for unruptured arteriovenous malformations: A propensity score weighted prospective cohort study"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9155-038X","authenticated-orcid":false,"given":"Heze","family":"Han","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital Capital Medical University  Beijing China"},{"name":"China National Clinical Research Center for Neurological Diseases  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