ESTRO 2024 - Abstract Book

S968

Clinical - CNS

ESTRO 2024

The haemorrhage rate stood at 4.3% (6 out of 138). Individual bleeding episodes were observed at intervals of 2, 4, 19, 47, 49, and 64 months post-SRS. The annual bleeding incidence was calculated to be 0.8% (6 bleeding events across 680 patient-years). Of these, two patients were admitted with hemorrhage as their primary symptom, while the other four presented with different symptoms. In terms of AVM location, three were found deeply seated, and three were located at the motor cortex. The average dosage at the margins was 22 Gy (ranging from 19-25 Gy). Every patient exhibited angiographic indicators associated with a heightened bleeding risk, including venous aneurysms, multiple venous drainage routes, and dual arterial supplies. Following a bleeding episode, emergency surgical interventions were deemed necessary in three cases. Notably, none of the patients underwent a second SRS procedure. Complete obliteration was observed in three patients within an average span of 39 months.

Conclusion:

Post-SRS bleeding risks associated with AVM treatments are inherent and persist even in patients who initially show no signs of hemorrhaging prior to achieving full obliteration. To mitigate the risk of hemorrhage, rigorous post radiosurgery monitoring is imperative. Additionally, addressing any residual nidus promptly after the latency phase is advisable to further reduce risks.

Keywords: AVM, SRS, Radiosurgery

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