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Do unruptured brain vessel malformations need preventative surgery?
Date:4/28/2010

(CHICAGO) Individuals diagnosed with a brain arteriovenous malformation (AVM), an abnormal tangle of arteries and veins, are at an increased risk of vessel rupture and bleeding that can cause stroke and permanent brain damage.

Traditionally, doctors have advocated preventative interventions, such as endovascular procedures, surgical resection, or radiation therapy, and sometimes a combination of these procedures, on the assumption that unruptured AVMs pose similar risk to AVMs that have bled. By removing the unruptured AVM, this will decrease the risk of hemorrhaging and provide patient's better outcomes.

However, more recent data suggests that the risk of brain hemorrhage from unruptured or accidentally discovered brain AVMs may actually be lower and less severe than initially believed.

Now, Rush University Medical Center is part of an international, multicenter, NIH-funded trial called, "A Randomized Unruptured Brain Arteriovenous Malformation (ARUBA)," which is the first randomized, clinical study to evaluate whether a hands-off approach or intervention using any combination of endovascular, neurosurgical, or radiation therapy is better for managing an AVM that has not ruptured.

"The risk of having an AVM is that it could potentially rupture, bleed, injure the brain, and cause symptoms of stroke," said Dr. Michael Chen, neuroendovascular surgeon at Rush University Medical Center, and site principal investigator of the study. "However, removing or closing up a brain AVM by means of surgery, radiation therapy or interventional therapy may also potentially injure brain tissue and cause a stroke."

"Learning that you have an AVM can be a traumatic experience for patients. They may fear they are walking around with a ticking time bomb in their head," said Chen, who also is an assistant professor in neurology, neurosurgery and radiology at Rush University. "But we do not really know how likely it is that an unruptu
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Contact: Deb Song
deb_song@rush.edu
312-942-0588
Rush University Medical Center
Source:Eurekalert

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