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They found an obliteration rate of 47% with Embo/SRS compared to 70% with SRS alone.
We achieved a fairly reasonable obliteration rate, which could potentially improve with further angiographic followup.
Of their prospectively planned stereotactic staged radiosurgery, the same authors reported a 36% actuarial obliteration rate at 5 years and a 56% obliteration rate at 10 years when including salvage treatments.
Our experience with embolization prior to SRS has been positive, albeit with a more modest 40% obliteration rate.
Mathis et al. [ 12] embolized 24 AVMs with a mean initial volume of 37 cm prior to GKR and noted a 50% obliteration rate with only 4% morbidity.
Pan et al. [ 11] reported only a 50% obliteration rate in 76 AVMs larger than 10 cm (mean dose 17 Gy).
Similar(42)
SRS offers acceptable obliteration rates with lower risks of hemorrhage occurring during the latency period.
In current practice, fractionated treatments divide the dose evenly into several fractions, which generally leads to low obliteration rates.
Cerebral arteriovenous malformation obliteration rates have increased with the advent of newer embolic agents and devices but complications exist, related to the angioarchitecture of the arteriovenous malformations, the types of agents used, and operator experience.
Some investigators reported that embolization may decrease obliteration rates and increase treatment morbidity [ 17].
Despite overall high obliteration rates and low complication rates, SRS efficacy remains severely limited in large and complex AVM.
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