Introduction Pure arterial malformations (PAM) are rare vascular lesions characterized by dilated, tortuous arterial loops without venous shunting. The natural history of these lesions remains unclear. We report the long-term clinical and radiological outcomes in the largest series of patients with PAM.
Methods Retrospective review at a tertiary academic referral center for patients with a PAM. Follow-up clinical and radiological data were collected and analyzed for clinical symptoms and radiographic changes.
Results Twenty-five patients met the inclusion criteria. The mean age at presentation was 30.9 ± 14 years. Nineteen (76%) patients were female and six (23.1%) were male. Eleven (44%) patients had ≥1 symptom at presentation, of which, only 3 (12%) could be linked to PAM. The most common symptom was headache (n=8). PAMs involved a single vessel in 16 (64%) cases and ≥2 vessels in 9 cases (36%). Fifteen (60%) lesions were isolated to the anterior circulation compared to 6 (24%) in the posterior circulation. The most frequently involved vessel was the supraclinoid internal cerebral artery (36%). An associated saccular aneurysm was present in 32% of patients. Ten lesions were partially calcified. The mean radiographic and clinical follow-up was 21.4 ± 26.6 months and 44.5 ± 34.8 months, respectively. None of the patients developed new symptoms related to their lesion or radiographic progression over the duration of follow-up.
Conclusion PAMs are rare incidental vascular lesions found most frequently in young, asymptomatic females. PAMs have a benign clinical and radiographic natural history and are best managed conservatively with serial imaging.
Disclosures S. Oushy: None. W. Brinjikji: None. H. Cloft: None. R. Vine: None. G. Lanzino: None.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.