{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T20:18:18Z","timestamp":1787689098649,"version":"build-2784847793"},"reference-count":27,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"accepted":{"date-parts":[[2024,12,14]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Brain arteriovenous malformations (AVMs) are abnormal connections between feeding arteries and draining veins, associated with significant risks of haemorrhage, seizures and other neurological deficits. Preoperative embolization is commonly used as an adjunct to microsurgical resection, with the aim of reducing intraoperative complications and improving outcomes. However, the efficacy and safety of this approach remain controversial.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This study is a subanalysis of the Multicenter International Study for Treatment of Brain AVMs consortium. We retrospectively analysed 486 patients with brain AVMs treated with microsurgical resection between January 2010 and December 2023. Patients were divided into two groups: those who underwent microsurgery alone (n=245) and those who received preoperative embolization, followed by microsurgery (n=241). Propensity score matching was employed, resulting in 288 matched patients (144 in each group). The primary outcomes were rates of complete AVM obliteration and functional outcomes (measured by the modified Rankin Scale (mRS)). Secondary outcomes included complication rates, mortality, hospital length of stay and postsurgical rupture.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>After matching, the complete obliteration rate was 97% with no significant difference between the microsurgery-only group and the preoperative embolization group (p=0.12). The proportion of patients with an mRS score of 0\u20132 at the last follow-up was similar in both groups (83% vs 84%; p=0.67). The median hospital stay was significantly longer for the embolisation group (9\u2009days vs 7\u2009days; p=0.017). Complication rates (24% vs 22%; p=0.57) and mortality rates (4.9% vs 2.1%; p=0.20) were comparable between the two groups. No significant differences were observed in postsurgical rupture, recurrence or retreatment rates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this large multicentre study, preoperative embolization did not significantly improve AVM obliteration rates, functional outcomes or reduce complications compared with microsurgery alone.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jnnp-2024-334974","type":"journal-article","created":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T13:21:46Z","timestamp":1738848106000},"page":"766-774","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Efficacy and safety of preoperative embolization in surgical treatment of brain arteriovenous malformations: a multicentre study with propensity score matching"],"prefix":"10.1136","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5208-8425","authenticated-orcid":false,"given":"Hamza","family":"Salim","sequence":"first","affiliation":[{"name":"Department of Radiology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA"},{"name":"Department of Neuroradiology, MD Anderson Medical Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawoud","family":"Hamdan","sequence":"additional","affiliation":[{"name":"Department of Radiology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimer","family":"Adeeb","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA"},{"name":"Department of Neurosurgery, UT Health Sciences Center at Houston, McGovern Medical School, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Kandregula","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8797-0808","authenticated-orcid":false,"given":"Assala","family":"Aslan","sequence":"additional","affiliation":[{"name":"Department of Radiology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4910-6090","authenticated-orcid":false,"given":"Basel","family":"Musmar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4600-8545","authenticated-orcid":false,"given":"Christopher S","family":"Ogilvy","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0131-5699","authenticated-orcid":false,"given":"Adam A","family":"Dmytriw","sequence":"additional","affiliation":[{"name":"Division of Diagnostic and Interventional Neuroradiology, Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Abdelsalam","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Miami, Coral Gables, Florida, 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8325-2382","authenticated-orcid":false,"given":"Muhammed Amir","family":"Essibayi","sequence":"additional","affiliation":[{"name":"Montefiore Einstein Cerebrovascular Research Lab and Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salem M","family":"Tos","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Texas at Houston, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Keles","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Wisconsin School of Medicine, Madison, Wisconsin, 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Living with a brain avm: a quality of life assessment. In: Esposito G , Regli L , Cenzato M , eds. Trends in Cerebrovascular Surgery and Interventions. 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Comparing stand-alone endovascular embolization versus stereotactic radiosurgery in the treatment of arteriovenous malformations with Spetzler-Martin grades I\u2013III: a propensity score matched study. J NeuroIntervent Surg 2024;jnis\u20132024. doi:10.1136\/jnis-2024-022326","DOI":"10.1136\/jnis-2024-022670"},{"key":"2025071606150576000_96.8.766.17","unstructured":"Citing RStudio . Posit Support, 2023. 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Surgical treatment of arteriovenous malformations: role of preoperative staged embolization. In: Esposito G , Regli L , Kaku Y , eds. Trends in the Management of Cerebrovascular Diseases. Cham: Springer International Publishing, 2018: 109\u201313.","DOI":"10.1007\/978-3-319-73739-3_16"},{"key":"2025071606150576000_96.8.766.25","doi-asserted-by":"publisher","DOI":"10.3171\/2019.2.JNS182743"},{"key":"2025071606150576000_96.8.766.26","first-page":"1078","article-title":"Surgery in Intracerebral Arteriovenous Malformations: The Role of Preoperative Embolization","volume":"33","author":"Ozden","year":"2023","journal-title":"Turk Neurosurg"},{"key":"2025071606150576000_96.8.766.27","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1054\/jocn.2000.0714","article-title":"Strategy for the treatment of arteriovenous malformations","volume":"7 Suppl 1","author":"Sano","year":"2000","journal-title":"J Clin Neurosci"}],"container-title":["Journal of Neurology, Neurosurgery &amp; Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jnnp-2024-334974","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T13:15:45Z","timestamp":1752671745000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnnp.bmj.com\/lookup\/doi\/10.1136\/jnnp-2024-334974"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,6]]},"references-count":27,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,7,16]]},"published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1136\/jnnp-2024-334974"],"URL":"https:\/\/doi.org\/10.1136\/jnnp-2024-334974","relation":{},"ISSN":["0022-3050","1468-330X"],"issn-type":[{"value":"0022-3050","type":"print"},{"value":"1468-330X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,6]]}}}