Impact of smoking on occlusion rates following stereotactic radiosurgery for Spetzler Martin grade I-III brain arteriovenous malformations - A propensity score matched analysis of the MISTA consortium.

Sconzo D., Ramirez-Velandia F., Muram S., Enriquez-Marulanda A., Riordan CP., Adeeb N., Musmar B., Salim HA., Kandregula S., Dmywtriw AA., Abdelsalam A., Ataoglu C., Erginoglu U., Kondziolka D., Aslan A., Naamani KE., Sheehan J., Park MS., Zeineddine HA., Ironside N., Kumbhare D., Gummadi S., Essibayi MA., Tos SM., Keles A., Rezai A., Pöppe J., Sen RD., Baskaya MK., Griessenauer CJ., Jabbour P., Tjoumakaris SI., Atallah E., Riina H., Abushehab A., Burkhardt J-K., Starke RM., Sekhar LN., Levitt MR., Altschul DJ., Haranhalli N., McAvoy M., Abla A., Stapleton C., Koch M., Srinivasan VM., Chen PR., Blackburn S., Kim LJ., Choudhri O., Pukenas B., Mantziaris G., O'Leary S., Kan P., Li Y-L., Simonato D., Bulsara K., Fuschi M., Alaraj A., Hanalioglu S., Patel A., Savardekar A., Cuellar H., Lawton M., Morcos J., Guthikonda B., Taussky P., Ogilvy CS., MISTA Consortiumn .

BACKGROUNDAND OBJECTIVE: The authors compareocclusion rates in grade I-III AVMs in smokers and non-smokers, using propensity score matching (PSM). METHODS: The authors performed a subgroup analysis of the MISTA consortium, a multicenter registry that includes patients aged 1 to 89 years with AVMs treated between January 2010 and December 2023. Only grade I-III AVMs were included. PSM was used to control confounders. Primary endpoints included angiographic obliteration. RESULTS: A total of 353 patients with bAVMs, with a median age of 37, were included in this study: 236 were never smokers, and 117 were current or previous smokers. After 1:1 PSM of smokers and non-smokers, 33 matched pairs were obtained. The smokers were more likely to display complete obliteration at last imaging follow-up compared to non-smokers (57.6 % vs. 27.3 %;p < 0.01). The median time to last clinical(p = 0.45)and angiographic(p = 0.33)follow up was not statistically different between the two groups.There were no statistically significant differences between the two matched groups in the incidence of post-SRS edema (p = 0.23), post-treatment rupture (0 %), overall mortality (p = 0.31), and functional status at the last follow-up (p = 0.69). CONCLUSION: Individuals with a positive history of smoking are more likely to achieve complete obliteration of grades I-III bAVMs following SRS treatment. However, smokers do not differ from non-smokers in terms of the incidence of post-treatment rupture, overall mortality, or functional status at the last follow-up.

DOI

10.1016/j.jocn.2025.111411

Type

Journal article

Publication Date

2025-09-01T00:00:00+00:00

Volume

139

Keywords

Arteriovenous Malformations, Occlusion, Smokers, Humans, Male, Female, Propensity Score, Intracranial Arteriovenous Malformations, Middle Aged, Adult, Radiosurgery, Adolescent, Aged, Child, Young Adult, Smoking, Aged, 80 and over, Child, Preschool, Registries, Treatment Outcome, Infant, Retrospective Studies

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