Association between draining vein diameters and intracranial arteriovenous malformation hemorrhage: a multicentric retrospective study

Purpose Intracranial arteriovenous malformations (AVMs) cause hemorrhage, and the role of draining vein diameters in rupture risk is controversial. The aims of the present study were to investigate the variables related with intracranial AVM rupture and to examine the association of draining vein di...

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Bibliographic Details
Published in:	Neuroradiology Vol. 62; no. 11; pp. 1497 - 1505
Main Authors:	de Castro-Afonso, Luís Henrique, Vanzim, José Ricardo, Trivelato, Felipe Padovani, Rezende, Marco Tulio, Ulhôa, Alexandre Cordeiro, Chodraui-Filho, Salomão Faroj, de Abreu Mattos, Luiz Gustavo, Mounayer, Charbel, Nakiri, Guilherme Seizem, Colli, Benedicto Oscar, Abud, Daniel Giansante
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 01-11-2020
Subjects:	Imaging Interventional Neuroradiology Medicine Medicine & Public Health Neurology Neuroradiology Neurosciences Neurosurgery Radiology Intracranial arteriovenous malformation Brain arteriovenous malformation Hemorrhage Bleeding Rupture
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Summary:	Purpose Intracranial arteriovenous malformations (AVMs) cause hemorrhage, and the role of draining vein diameters in rupture risk is controversial. The aims of the present study were to investigate the variables related with intracranial AVM rupture and to examine the association of draining vein diameters and AVM hemorrhage. Methods Two hundred three patients were included in this study, of which 117 (57%) had unruptured AVMs, and 86 (43%) had ruptured AVMs. Results In an adjusted (multivariate) analysis, the variables significantly associated with AVM hemorrhagic presentation were age (OR per year increase 0.97, 95%CI 0.95–0.99, p = 0.007), a deep nidus compared with superficial nidus (OR 3.21, 95%CI 1.13–9.06, p = 0.028), the nidus diameter (OR per each mm increase 0.95, 95%CI 0.92–0.97, p < 0.001), a single draining vein compared with multiple draining veins (OR 2.14, 95%CI 1.02–4.50, p = 0.044), the draining vein diameter (OR per mm increase 1.52, 95%CI 1.26–1.83, p < 0.001), and a draining vein diameter ≥ 5 mm compared with < 5 mm (OR 5.80, 95%CI 2.70–12.47, p < 0.001). Conclusion In this study, after adjusted analysis, the variables associated with intracranial AVM hemorrhagic presentation were a young age, a small nidus diameter, a deeply located nidus, a single draining vein, and large draining vein diameters. A draining vein diameter cutoff ≥ 5 mm was positively associated with the risk of AVM rupture. A large and prospective study is now necessary to confirm if draining vein diameter is a risk factor for AVM hemorrhage.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Undefined-2
ISSN:	0028-3940 1432-1920
DOI:	10.1007/s00234-020-02484-y