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CC BY 4.0 · Indian Journal of Neurosurgery 2025; 14(S 01): S35-S40
DOI: 10.1055/s-0045-1810448
Original Article

Longitudinal Assessment of Stereotactic Radiosurgery Outcomes in Brain Arteriovenous Malformations: Continuous Monitoring of Treatment Effects

Authors

  • Prem Kumar Reddy Gopireddy 

    1   Department of Neurosurgery, Ruby Hall Clinic, Pune, Maharashtra, India

  • Ashok Bhanage

    1   Department of Neurosurgery, Ruby Hall Clinic, Pune, Maharashtra, India

  • Anand Katkar

    1   Department of Neurosurgery, Ruby Hall Clinic, Pune, Maharashtra, India

  • Ashok Hande

    1   Department of Neurosurgery, Ruby Hall Clinic, Pune, Maharashtra, India

  • Rahul Sharma

    1   Department of Neurosurgery, Ruby Hall Clinic, Pune, Maharashtra, India

  • Ajay Kaushik

    1   Department of Neurosurgery, Ruby Hall Clinic, Pune, Maharashtra, India

  • Chintan Popat

    1   Department of Neurosurgery, Ruby Hall Clinic, Pune, Maharashtra, India

  • Neeraj Dhingra

    2   Department of Radiation Oncology, Ruby Hall Clinic, Pune, Maharashtra, India

  • Sathiyanarayanan Kumaraswami Vatyam

    2   Department of Radiation Oncology, Ruby Hall Clinic, Pune, Maharashtra, India

  • Raghavendra Holla

    2   Department of Radiation Oncology, Ruby Hall Clinic, Pune, Maharashtra, India
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Abstract

Background

Arteriovenous malformations (AVMs) present significant treatment challenges due to their hemorrhage risk and associated neurological deficits. Stereotactic radiosurgery (SRS) is a technique designed to obliterate AVMs while minimizing complications.

Objective

This study aims to evaluate the obliteration rate and clinical outcomes of patients undergoing SRS using linear accelerators (LINAC) for the treatment of brain AVMs.

Materials and Methods

This retrospective and prospective study included 56 consecutive patients who underwent SRS for AVMs between 2008 and 2021, with the study period till 2023. The mean patient age was 29.21 years (range: 8–67 years). Complete obliteration rates and clinical improvements were assessed, and statistical analysis was conducted using SPSS.

Results

The mean planning target volume was 11.39 cc (median: 7.74 cc) and the average modified AVM score was 1.79 (median: 1.56). The obliteration rate was 83.92%, with 7.1% of patients exhibiting residual AVM and 5.3% requiring surgical excision. Post-radiation hemorrhage occurred in 7.14% of cases.

Conclusion

LINAC-based SRS proves to be a highly effective and safe treatment modality for small or surgically inaccessible brain AVMs.

Keywords

stereotactic radiosurgery - brain arteriovenous malformations - LINAC - complete obliteration - clinical improvement

Authors' Contribution

P.K.R.G.: study design, data collection, manuscript writing, and data analysis. A.B.: study design, manuscript proof reading, and data analysis. A.H.: study design, manuscript proof reading, and data analysis. A.K.: study design and manuscript writing. R.S.: study design, manuscript proof reading, and data interpretation. A.K.: manuscript writing and data collection. C.P.: manuscript writing and data collection. N.D.: study design, manuscript writing, and data analysis. S.K.V.: manuscript writing and proof reading, and data analysis. R.H.: manuscript writing and data analysis.




Publication History

Article published online:
28 July 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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