1. EBS Presentation
Does an AVM recur after microsurgical resection
with a negative post operative angiogram?
Nirav J. Patel
17th November, 2011
Advanced Scholar: Morgan

2. Introduction and Terms
• Most authors state that adult AVMs are “cured” after
microsurgery, with a negative post operative
angiogram.
– However, this is questioned, since there are some case
reports, especially in the paediatric population.
• Recur: After microsurgery and negative post op
angiogram, we find an AVM, either by MRI, angiogram
or clinical (bleed).
– Recur may be due to de novo formation, regrowth of missed
AVM, regrowth from the same bed etc.
• Clinical Purpose: Can we tell a patient that
after AVM surgery, if the angiogram shows no
AVM, that they are cured forever?

3. Search strategy
• P = Patients after microsurgical resection with
negative postoperative angiogram.
• I = follow up: angiogram, MRI, clinical
• C=
• O = Recurrence by imaging or clinical
• Ovid Medline, Scopus

4. Search terms
• P=
– Intracranial Arteriovenous Malformations, brain
arteriovenous malformation*, intracranial
angioma*;
– Microsurgery, Neurosurgical Procedures, Surgical
Procedures, operative, surg*, resect*, extirpat*, ex
cis*
• Outcome:
– Recurrence, rebleed, reh*emorrhage, late
he*morrhag, late bleed*, recur*

5. Ovid Medline – Session 1

6. Scopus

7. • Scopus search terms:
• "intracranial arteriovenous malformation*" or
"cerebral arteriovenous malformation*" or
"brain arteriovenous malformation*" or
"intracranial angioma*" AND
• *surg* or resect* or extirpat* or excis* AND
• recurr* or rebleed* or reh*emorrhag* or "late
h*emorrhag*" or "late bleed*"
• LIMITS: English and Human

8. • Excel Table

9. Conclusion
• AVMs can recur.
• The incidence is not known due to limitation in
databases, including follow up of all cases
(surgeons may follow with imaging since most
don’t recur).
• 10 adults
• 32 peds
• The results of this search support that further
studies are needed to know the incidence of
recurrence and which patients need follow up
imaging after resection.