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We read with interest the recent excellent work by Hak and colleagues on the recurrence of pediatric brain arteriovenous malformations (AVM) following successful treatment.1 Their study describes an eye-opening 15% recurrence rate in a retrospectively analyzed cohort of 70 children with AVMs and an 11% recurrence rate in an accompanying meta-analysis. These results are in agreement with the findings of two other studies from the past 18 months that each report a 10.4% recurrence rate, one in a cohort of 67 children2 and another in a cohort of 115 children.3 All three papers established younger age as a risk factor for recurrence. Other factors that may portend a higher risk of recurrence include hemorrhagic presentation and treatment modality.2 3
These authors, and others, have concluded that long-term imaging protocols are necessary for children even after angiographically confirmed AVM cure, and that the …
Contributors All authors have met ICMJE criteria for authorship, and all authors have read and approved the submitted manuscript. Study conception: DCL and APK. APK. Manuscript writing: DCL, AV, and APK. Critical revision: AV, APK. Final approval: DCL, AV, APK.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests APK is a consultant for Penumbra and Microvention.
Provenance and peer review Not commissioned; internally peer reviewed.
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