Most Promising Approaches to Improve Brain AVM Management: ARISE I Consensus Recommendations

Authors

Edgar A. Samaniego, Department of Neurology, Neurosurgery and Radiology, University of Iowa (E.A.S.).
Guilherme Dabus, Department of Neurosurgery, Baptist Health, Miami, FL (G.D.).
Philip M. Meyers, Department of Radiology and Neurological Surgery, Columbia University, New York (P.M.M.).
Peter T. Kan, Department of Neurological Surgery, University of Texas Medical Branch Galveston (P.T.K.).
Juhana Frösen, Department of Rehabilitation, Tampere University Hospital, Finland (J.F.).
Giuseppe Lanzino, Department of Neurosurgery, Mayo Clinic, Rochester, MN (G.L.).
Babu G. Welch, Departments of Neurological Surgery and Radiology; The University of Texas Southwestern, Dallas (B.G.W.).
Victor Volovici, Department of Neurosurgery, Erasmus MC University Medical Centre, Rotterdam, the Netherlands (V.V.).
Fernando Gonzalez, Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD (F.G.).
Johana Fifi, Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York (J.F., A.B.).
Fady T. Charbel, Department of Neurosurgery, University of Illinois at Chicago (F.T.C.).
Brian L. Hoh, Department of Neurosurgery, College of Medicine, University of Florida, Gainesville (B.L.H.).
Alexander Khalessi, Department of Neurosciences, University of California, San Diego (A.K.).
Michael P. Marks, Interventional Neuroradiology Division, Stanford University Medical Center, Palo Alto, CA (M.P.M.).
Alejandro Berenstein, Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York (J.F., A.B.).
Victor M. Pereira, Department of Neurosurgery, St. Michael's Hospital, Toronto, Canada (V.M.P.).
Mark Bain, Department of Neurological Surgery, Cleveland Clinic, OH (M.B.).
Geoffrey P. Colby, Department of Neurosurgery, University of California Los Angeles (G.P.C.).
Sandra Narayanan, Neurointerventional Program and Comprehensive Stroke Program, Pacific Neuroscience Institute, Santa Monica, CA (S.N.).
Satoshi Tateshima, Division of Interventional Neuroradiology, Ronald Reagan UCLA Medical Center, Los Angeles (S.T.).
Adnan H. Siddiqui, Department of Neurosurgery, Gates Vascular Institute, Buffalo, New York (A.H.S.).
Ajay K. Wakhloo, Department of Radiology, Tufts University School of Medicine, Boston, MA (A.K.W.).
Adam S. Arthur, Department of Neurosurgery, Semmes-Murphey Clinic, University of Tennessee Health Science Center, Memphis (A.S.A.).
Michael T. Lawton, Neurosurgery, Barrow Neurological Institute, Phoenix, AZ (M.T.L.).

Document Type

Article

Abstract

Brain arteriovenous malformations (bAVMs) are complex, and rare arteriovenous shunts that present with a wide range of signs and symptoms, with intracerebral hemorrhage being the most severe. Despite prior societal position statements, there is no consensus on the management of these lesions. ARISE (Aneurysm/bAVM/cSDH Roundtable Discussion With Industry and Stroke Experts) was convened to discuss evidence-based approaches and enhance our understanding of these complex lesions. ARISE identified the need to develop scales to predict the risk of rupture of bAVMs, and the use of common data elements to perform prospective registries and clinical studies. Additionally, the group underscored the need for comprehensive patient management with specialized centers with expertise in cranial and spinal microsurgery, neurological endovascular surgery, and stereotactic radiosurgery. The collection of prospective multicenter data and gross specimens was deemed essential for improving bAVM characterization, genetic evaluation, and phenotyping. Finally, bAVMs should be managed within a multidisciplinary framework, with clinical studies and research conducted collaboratively across multiple centers, harnessing the collective expertise and centralization of resources.

Medical Subject Headings

Humans; Cerebral Hemorrhage (therapy); Endovascular Procedures (methods); Intracranial Arteriovenous Malformations (therapy); Radiosurgery (methods)

Publication Date

5-1-2024

Publication Title

Stroke

E-ISSN

1524-4628

Volume

55

Issue

5

First Page

1449

Last Page

1463

PubMed ID

38648282

Digital Object Identifier (DOI)

10.1161/STROKEAHA.124.046725

Recommended Citation

Samaniego, Edgar A.; Dabus, Guilherme; Meyers, Philip M.; Kan, Peter T.; Frösen, Juhana; Lanzino, Giuseppe; Welch, Babu G.; Volovici, Victor; Gonzalez, Fernando; Fifi, Johana; Charbel, Fady T.; Hoh, Brian L.; Khalessi, Alexander; Marks, Michael P.; Berenstein, Alejandro; Pereira, Victor M.; Bain, Mark; Colby, Geoffrey P.; Narayanan, Sandra; Tateshima, Satoshi; Siddiqui, Adnan H.; Wakhloo, Ajay K.; Arthur, Adam S.; and Lawton, Michael T., "Most Promising Approaches to Improve Brain AVM Management: ARISE I Consensus Recommendations" (2024). Neurosurgery. 2017.
https://scholar.barrowneuro.org/neurosurgery/2017