title: Gamma Knife Radiosurgery for Arteriovenous Malformations: Clinical Series of 199 Patients.
abstract: OBJECTIVE
  Cerebral arteriovenous malformations (AVM) are pathological connections between arteries and veins without capillaries. Stereotactic radiosurgery (RS) is a proven and accepted treatment method for cerebral AVMs. Our objective was to analyze the factors influencing the clinical outcome in patients suffering from AVMs.
  
  
  METHODS
  We retrospectively reviewed 199 patients who were treated with Gamma-Knife RS for intracranial AVMs between 13 October 2005 and 31 October 2010. There were 89 male, 110 female patients with a median age of 32 years (range, 3-74 years). Obliteration was assessed with MRI angiography and DSA imaging.
  
  
  RESULTS
  Complete obliteration rate after RS was 71 % (141 out of 199), including second RS treatments. In terms of obliteration rates, there was no significant difference between patients younger and older than 21 years old (p=0.669). After RS, 3 patients died due to intracranial hemorrhage and 1 died of heart disease. Death from AVM was determined as 1.5 %. Intracranial hemorrhage was observed in 7 (3.5 %) patients post-RS.
  
  
  CONCLUSIONS
  Obliteration was found to be associated with Spetzler-Martin Grade, Pollock-Flickinger Grade, AVM volume, RS dose, bleeding history before RS and no previous embolization before RS. Gamma knife RS is an effective treatment method for the treatment of AVMs both for pediatric and adult patients. It provides high obliteration and low mortality rates.
authors: Gaziosmanpasa University, Department of Radiation Oncology, Tokat, Turkey.
authors: Ipek
authors: I
authors: Arslan
authors: Evrim
authors: E
authors: Tezcanli
authors: Meltem
authors: M
authors: Yilmaz
authors: Olcay
authors: O
authors: Cizmeli
authors: Meric
authors: M
authors: Sengoz
authors: Selcuk
authors: S
authors: Peker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D002533:Cerebral Angiography; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000601:surgery*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D016634:Radiosurgery / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult