%0 Journal Article %A Christina Iosif %A Adson Freitas de Lucena %A Luiz Gustavo Abreu-Mattos %A Victor Hugo Espindola Ala %A Amin El-Ghanam %A Suzana Saleme %A Francois Caire %A Charbel Mounayer %T Curative endovascular treatment for low-grade Spetzler-Martin brain arteriovenous malformations: a single-center prospective study %D 2019 %R 10.1136/neurintsurg-2018-014390 %J Journal of NeuroInterventional Surgery %P 699-705 %V 11 %N 7 %X Background The treatment of low grade Spetzler-Martin (SM) brain arteriovenous malformations (AVMs) has been debated in unruptured cases. Nevertheless, in clinical practice there are cases where treatment is preferred; in these cases a very low complication rate is mandatory. In ruptured cases, early and complete obliteration of the nidus is the preferred strategy.Objective To achieve curative embolization, ideally in a single session, by dual microcatheterization techniques with arterial and/or venous access, according to the angioarchitecture.Materials and methods This is a prospective, single-center study carried out between January 2008 and January 2016. Patients with ruptured and unruptured brain AVMs, with SM grades I and II, treated by endovascular means, were included. Demographics, clinical presentation, angioarchitecture, and procedure-related complications were analyzed. Angiographic and clinical results were reported.Results Seventy-three patients, aged 40.5±17.8 years, were included. More than 60% of the patients presented with ruptured AVMs. Initial SM grades were I for 22% and II for 78% of the patients. Preprocedural modified Rankin Scale (mRS) score was 0–2 for 53 (72.6%), 3 for 12 (16.4%), 4 for 5 (6.8%) and 5 for 3 (4.1%) patients. Procedure-related morbidity was 2.7% and procedure-related mortality was 0%. Ninety percent (90.5%) of the patients were independent in their everyday lives (mRS score 0–2) at 6 months. In all but one case (95%) the embolization was curative.Conclusion Stand-alone endovascular treatment for SM grade I and II brain AVMs seems safe and effective, allowing for complete obliteration of the nidus, with low complication rates. A study of larger cohorts is needed. %U https://jnis.bmj.com/content/neurintsurg/11/7/699.full.pdf