TY - JOUR
T1 - Complications after Gamma Knife Radiosurgery for Brain AVMs
T2 - Predictive factors for symptomatic radionecrosis
AU - Branko, Popadic
AU - Cervo, Amedeo
AU - Macera, Antonio
AU - Pero, Guglielmo
AU - Valente, Giada
AU - Scheichel, Florian
AU - Sherif, Camillo
AU - Picano, Marco
AU - Cenzato, Marco
AU - La Camera, Alessandro
AU - Piano, Mariangela
N1 - Publisher Copyright:
© The Author(s) 2025.
PY - 2025/4/23
Y1 - 2025/4/23
N2 - PURPOSE: The aim of this study is to investigate complications after Gamma Knife Radiosurgery (GKRS) for AVMs and predictive factors for symptomatic radionecrosis.METHODS: A retrospective single centre study on AVMs treated with GKRS between 2008 and 2016 was performed.RESULTS: A total of 209 patients were included. AVM obliteration was seen in 70%, while radiation induced changes (RIC) were detected in 45%. Symptomatic radionecrosis was found in 13 patients (6.2%). Furthermore, 12 patients (5.7%) experienced latent period haemorrhage. Predictors of symptomatic radionecrosis were 12 Gy volume (p = 0.007), RIC grade (p = < 0.0001) and ≥ 2 endovascular treatments (p = 0.001) in univariate analysis, while age (p = 0.043), RIC grade (p = 0.0002) and ≥ 2 endovascular procedures (p = 0.002) were identified in multivariate analysis.CONCLUSION: Complication after GKRS for AVMs were latent period haemorrhage in 5.7% and symptomatic radionecrosis in 6.2%. Age, RIC grade and ≥ 2 endovascular procedures were risk factors for symptomatic radionecrosis. Due to the unclear benefits of endovascular procedures in addition to GRKS and its potential negative effects, the indication for endovascular treatment should be weighed carefully.
AB - PURPOSE: The aim of this study is to investigate complications after Gamma Knife Radiosurgery (GKRS) for AVMs and predictive factors for symptomatic radionecrosis.METHODS: A retrospective single centre study on AVMs treated with GKRS between 2008 and 2016 was performed.RESULTS: A total of 209 patients were included. AVM obliteration was seen in 70%, while radiation induced changes (RIC) were detected in 45%. Symptomatic radionecrosis was found in 13 patients (6.2%). Furthermore, 12 patients (5.7%) experienced latent period haemorrhage. Predictors of symptomatic radionecrosis were 12 Gy volume (p = 0.007), RIC grade (p = < 0.0001) and ≥ 2 endovascular treatments (p = 0.001) in univariate analysis, while age (p = 0.043), RIC grade (p = 0.0002) and ≥ 2 endovascular procedures (p = 0.002) were identified in multivariate analysis.CONCLUSION: Complication after GKRS for AVMs were latent period haemorrhage in 5.7% and symptomatic radionecrosis in 6.2%. Age, RIC grade and ≥ 2 endovascular procedures were risk factors for symptomatic radionecrosis. Due to the unclear benefits of endovascular procedures in addition to GRKS and its potential negative effects, the indication for endovascular treatment should be weighed carefully.
KW - Humans
KW - Radiosurgery/adverse effects
KW - Male
KW - Female
KW - Middle Aged
KW - Retrospective Studies
KW - Adult
KW - Intracranial Arteriovenous Malformations/radiotherapy
KW - Radiation Injuries/etiology
KW - Necrosis/etiology
KW - Aged
KW - Adolescent
KW - Young Adult
KW - Postoperative Complications/etiology
KW - Risk Factors
KW - Treatment Outcome
KW - Endovascular Procedures
UR - http://www.scopus.com/inward/record.url?scp=105003211561&partnerID=8YFLogxK
U2 - 10.1007/s00701-025-06532-5
DO - 10.1007/s00701-025-06532-5
M3 - Journal article
C2 - 40266393
SN - 0001-6268
VL - 167
SP - 118
JO - Acta Neurochirurgica
JF - Acta Neurochirurgica
IS - 1
M1 - 118
ER -