Turkish Neurosurgery
Hybrid Operating Room for the Treatment of Spetzler–Martin Grade III–V Brain Arteriovenous Malformation: An Institutional Experience
Jiao Cheng2, Bingwei Song1, Liang He1, Ke Yan1, Linhai Shen1, Kai Hu2, Yong Zhen1
1Northern Jiangsu People’s Hospital Affiliated to Yangzhou University, Department of neursurgery, Yang zhou,
2The Yangzhou School of Clinical Medicine of Dalian Medical University, Department of neursurgery, Yang zhou,
DOI: 10.5137/1019-5149.JTN.45444-23.1

Aim:This study aimed to report our institutional experience of the one-stop treatment of Spetzler–Martin grade (SMG) III–V brain arteriovenous malformations (BAVMs) in a hybrid operating room.Material and Methods:Clinical data obtained from all patients with SMG III–V 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 III–V BAVMs with a low rate of postoperative complications.

Corresponding author : Yong Zhen