RT Journal Article SR Electronic T1 Pediatric brain arteriovenous malformation recurrence: a cohort study, systematic review and meta-analysis JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP 611 OP 617 DO 10.1136/neurintsurg-2021-017777 VO 14 IS 6 A1 Jean-Francois Hak A1 Gregoire Boulouis A1 Basile Kerleroux A1 Sandro Benichi A1 Sarah Stricker A1 Florent Gariel A1 Lorenzo Garzelli A1 Philippe Meyer A1 Manoelle Kossorotoff A1 Nathalie Boddaert A1 Vincent Vidal A1 Nadine Girard A1 Volodia Dangouloff-Ros A1 Francis Brunelle A1 Heather Fullerton A1 Steven W Hetts A1 Thomas Blauwblomme A1 Olivier Naggara YR 2022 UL http://jnis.bmj.com/content/14/6/611.abstract AB Background Recurrence following obliteration of brain arteriovenous malformations (AVMs) is common in children surgically treated, but recurrences following endovascular (EVT) and radiosurgical approaches are scantily reported.Objective To analyze the rates and risk factors for AVM recurrence after obliteration in a single-center cohort of children with ruptured AVMs treated with multimodal approaches, and to carry out a comprehensive review and meta-analysis of current data.Methods Children with ruptured AVMs between 2000 and 2019 enrolled in a prospective registry were retrospectively screened and included after angiographically determined obliteration to differentiate children with/without recurrence. A complementary systematic review and meta-analysis of studies investigating AVM recurrence in children between 2000 and 2020 was aggregated to explore the overall recurrence rates across treatment modalities by analyzing surgery versus other treatments.Results Seventy children with obliterated AVMs were included. AVM recurrences (n=10) were more commonly treated with EVT as final treatment (60% in the recurrence vs 13.3% in the no-recurrence group, p=0.018). Infratentorial locations were associated with earlier and more frequent recurrences (adjusted relative risk=4.62, 95% CI 1.08 to 19.04; p=0.04).In the aggregate analysis, the pooled rate of AVM recurrence was 10.9% (95% CI 8.7% to 13.5%). Younger age at presentation was associated with more frequent recurrences (RR per year increase, 0.97, 95% CI 0.93 to 0.99; p=0.046).Conclusion Location of infratentorial AVMs and younger age at presentation may be associated with earlier and more frequent recurrences. The higher rates of recurrence in patients with AVMs obliterated with EVT questions its role in an intent-to-cure approach and reinforces its position as an adjunct to surgery and/or radiosurgery.Data are available upon reasonable request.