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O12/125  CHOICE, prospective multicenter study of endovascular treatment for cerebral AVMs treated with SQUID: clinical and angiographic results at 1 year
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  1. Laurent Spelle1,
  2. Gyula Gal2,
  3. Xavier Barreau3,
  4. Emmanuel Houdart4,
  5. Markus Möhlenbruch5,
  6. Jean-Christophe Gentric6,
  7. Chrisanthi Papagiannaki7,
  8. Christophe Cognard8,
  9. Michel Piotin9,
  10. Yaakov Amsalem10,
  11. Ansgar Berlis11,
  12. Stephan Meckel12,
  13. Laurent Pierot13,
  14. Maurits Voormolen14,
  15. Serge Bracard15,
  16. Luca Valvassori16,
  17. Elke Gizewski17,
  18. Werner Weber18,
  19. Thomas Liebig19,
  20. Francis Turjman20,
  21. Emmanuel Chabert21,
  22. Denis Trystram22,
  23. Luc Defreyne23,
  24. Alain Bonafe24,
  25. Jildaz Caroff1
  1. 1Bicêtre Hospital, Department of Interventional Neuroradiology, Paris, France
  2. 2Odense University Hospital, Department of Radiology, Odense, Denmark
  3. 3CHU Pellegrin, Department of Diagnostic and Interventional Neuroimaging, BORDEAUX, France
  4. 4Lariboisière Hospital, Department of Neuroradiology, Paris, France
  5. 5Heidelberg University Hospital, Department of Neuroradiology, Heidelberg, Germany
  6. 6Brest University Hospital, Department of Neuroradiology, Brest, France
  7. 7CHU Rouen, Department of Radiology, Rouen, France
  8. 8CHU Toulouse, Department of Diagnostic and Therapeutic Neuroradiology, Toulouse, France
  9. 9Rothschild Foundation Hospital, Department of Interventional Neuroradiology, Paris, France
  10. 10Shaare Zedek Medical Center, Department of Interventional Neuroradiology, Jerusalem, Israel
  11. 11University Hospital Augsburg, Department of Diagnostic and Interventional Neurology, Augsburg, Germany
  12. 12University of Freiburg, Department of Neuroradiology, Freiburg, Germany
  13. 13University Hospital Reims, Department of Radiology, Reims, France
  14. 14Antwerp University Hospital (UZA), Department of Radiology, Edegem, Belgium
  15. 15University of Lorraine, Department of Diagnostic and Therapeutic Neuroradiology, Nancy, France
  16. 16ASST Monza, Department of Neuroradiology, Monza, Italy
  17. 17Medical University Innsbruck, Department of Neuroradiology, Innsbruck, Austria
  18. 18University Hospital of Bochum, Department of Diagnostic and Interventional Radiology, Bochum, Germany
  19. 19Ludwig-Maximilians University Hospital, Department of Neuroradiology, Munich, Germany
  20. 20Hôpital Neurologique Pierre-Wertheimer, Department of Interventional Neuroradiology, Lyon, France
  21. 21CHU de Clermont-Ferrand, Department of Neuroradiology, CLERMONT FERRAND, France
  22. 22Sainte-Anne Hospital, Psychiatry and Neurosciences, Paris, France
  23. 23Ghent University Hospital, Department of Vascular and Interventional Radiology, Ghent, Belgium
  24. 24CHU de Montpellier-Guy de Chauliac, Department of Neuroradiology, Montpellier, France

Abstract

Introduction Most brain arteriovenous malformations (bAVM) are or become symptomatic over time with a persistent risk of rupture. bAVM treatment remains challenging and standard practices continue to evolve.

Aim of Study The purpose of this study is to assess the bAVM treatment with SQUID embolic agent by embolization alone or in combination with other treatments.

Methods A European, prospective, observational, multicenter study including 21 centers was performed on patients with previously untreated bAVM followed for 1 year. The primary safety endpoint was the morbi-mortality assessed at the 3/6-month visit post endovascular phase or before any complementary treatment.

Results Between May-2018 and August-2020, 109 patients were enrolled (mean age 46.3±15, 50.5% male). bAVM were located in the left side in 55% of the cases, in the supratentorial region in 76.1% and in the eloquent site in 57.8%. Most bAVMs were Spetzler-Martin grade I-II (67%). Mean bAVM diameter was 2.3±1.5 and the nidus was small (<3 mm) in 78.9% of cases. 80.7% of the patients had a baseline mRS score of 0–2. Most patients underwent embolization alone (80.7%) and 19.3% received complementary treatment (85.7% underwent neurosurgery and 14.3% radiotherapy). The morbi-mortality related to SQUID or the procedure was 6.4% at 3/6-month and decreased to 4.9% at 1 year. No mortality related to SQUID or the procedure occurred. At 3/6-month, 63.2% of patients treated with embolization alone achieved a complete occlusion.

Conclusion These results reflect the use of SQUID in real-world conditions and confirm its safety and efficacy in the management of bAVM.

Disclosure of Interest Nothing to disclose.

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