Aim:This study aimed to report our institutional experience of the one-stop treatment of SpetzlerMartin grade (SMG) IIIV brain arteriovenous malformations (BAVMs) in a hybrid operating room.
Material and Methods:Clinical data obtained from all patients with SMG IIIV BAVMs who underwent one-stop treatment in a hybrid operating room were analyzed. The measures included imaging characteristics, intraoperative blood loss, postoperative complications, residual lesions, and the presence of postoperative recurrence. Outcomes were assessed using the Glasgow outcome scale (GOS) score at 6 months postsurgery.
Results:A total of 16 patients were included in this study, of whom 7 underwent endovascular embolization followed by microsurgical resection and 9 underwent intraoperative cerebral angiography-assisted microsurgery. The average intraoperative blood loss was 473.3 mL. Remnant of BAVMs was found on the intraoperative cerebral angiography of one patient. Two patients underwent decompressive craniectomy due to postoperative cerebral swelling, including one patient with occipital lobe cerebral infarction and aphasia. No mortality was recorded. At the 6-month postoperative follow-up, the GOS scores were 3 (n = 4, 25.0%), 4 (n = 4, 25.0%), and 5 (n = 8, 50.0%). No recurrence was noted in any of the postoperative reexaminations of brain digital subtraction angiography (DSA)
Conclusion:It is evident that a hybrid operating room can fully combine the advantages of microsurgery and endovascular interventions, allowing for a high resection rate in the surgical treatment of SMG IIIV BAVMs with a low rate of postoperative complications.
