Abstract TP587: Microsurgery Treatment Rate for Unruptured Cerebral Arteriovenous Malformations is Increased post-ARUBA

• Published in: Stroke (1970) 2019-02, Vol.50 (Suppl_1)
• Main Authors: Birnbaum, Lee A, Straight, Matthew, Lacci, John V, de Leonni Stanonik, Mateja, Mascitelli, Justin R, McDougall, Cameron M, Caron, Jean-Louis R
• Format: Article
• Language: English
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/str.50.suppl_1.TP587

Abstract only Background: The ARUBA trial reported medical management was superior to intervention for unruptured cerebral arteriovenous malformations (cAVMs); however, open excision was underrepresented in the intervention arm. We investigated whether the ARUBA trial results influenced treatment modality rates for unruptured cAVMs within the United States. Methods: We queried the National Inpatient Sample (NIS), the largest all-payer inpatient care database in the United States, and identified 2,028 patients that underwent treatment for unruptured cAVMs between January 2011 and September 2015. All screened subjects had AVM ICD-9-CM diagnosis code 747.81 (anomalies of cerebrovascular system) and were excluded based on hemorrhage codes 430 (SAH) and/or 431 (ICH). ICD-9-CM principal procedure codes were used to identify treatment modalities: endovascular (39.72), open excision (01.59), and stereotactic radiosurgery (SRS) (92.30-.39). Univariate logistic regression was used to compare treatment rates for each modality before and after two ARUBA time points: 1) European Stroke Conference (ESC) presentation May 2013 and 2) The Lancet publication February 2014. Results: When unruptured cAVMs were treated, the rate of open excision was greater after, compared to before, the May 2013 ARUBA presentation (OR 1.22, p