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Acta Neurochirurgica

, Volume 159, Issue 6, pp 1059–1064 | Cite as

European consensus conference on unruptured brain AVMs treatment (Supported by EANS, ESMINT, EGKS, and SINCH)

  • Marco CenzatoEmail author
  • Edoardo Boccardi
  • Ettore Beghi
  • Peter Vajkoczy
  • Istvan Szikora
  • Enrico Motti
  • Luca Regli
  • Andreas Raabe
  • Shalva Eliava
  • Andreas Gruber
  • Torstein R. Meling
  • Mika Niemela
  • Alberto Pasqualin
  • Andrey Golanov
  • Bengt Karlsson
  • Andras Kemeny
  • Roman Liscak
  • Bodo Lippitz
  • Matthias Radatz
  • Alessandro La Camera
  • René Chapot
  • Civan Islak
  • Laurent Spelle
  • Alberto Debernardi
  • Elio Agostoni
  • Martina Revay
  • Michael K. Morgan
Original Article - Conference Report

Abstract

In December of 2016, a Consensus Conference on unruptured AVM treatment, involving 24 members of the three European societies dealing with the treatment of cerebral AVMs (EANS, ESMINT, and EGKS) was held in Milan, Italy. The panel made the following statements and general recommendations: (1) Brain arteriovenous malformation (AVM) is a complex disease associated with potentially severe natural history; (2) The results of a randomized trial (ARUBA) cannot be applied equally for all unruptured brain arteriovenous malformation (uBAVM) and for all treatment modalities; (3) Considering the multiple treatment modalities available, patients with uBAVMs should be evaluated by an interdisciplinary neurovascular team consisting of neurosurgeons, neurointerventionalists, radiosurgeons, and neurologists experienced in the diagnosis and treatment of brain AVM; (4) Balancing the risk of hemorrhage and the associated restrictions of everyday activities related to untreated unruptured AVMs against the risk of treatment, there are sufficient indications to treat unruptured AVMs grade 1 and 2 (Spetzler–Martin); (5) There may be indications for treating patients with higher grades, based on a case-to-case consensus decision of the experienced team; (6) If treatment is indicated, the primary strategy should be defined by the multidisciplinary team prior to the beginning of the treatment and should aim at complete eradication of the uBAVM; (7) After having considered the pros and cons of a randomized trial vs. a registry, the panel proposed a prospective European Multidisciplinary Registry.

Keywords

Unruptured brain AVM Arteriovenous malformation Consensus Conference EANS EGKS ESMINT ARUBA 

Notes

Acknowledgments

We gratefully acknowledge the financial support by B. Braun that offered an unrestricted educational grant.

Compliance with ethical standards

Conflicts of interest

None.

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Copyright information

© Springer-Verlag Wien 2017

Authors and Affiliations

  • Marco Cenzato
    • 1
    Email author
  • Edoardo Boccardi
    • 2
  • Ettore Beghi
    • 3
  • Peter Vajkoczy
    • 4
  • Istvan Szikora
    • 5
  • Enrico Motti
    • 6
  • Luca Regli
    • 7
  • Andreas Raabe
    • 8
  • Shalva Eliava
    • 9
  • Andreas Gruber
    • 10
  • Torstein R. Meling
    • 11
  • Mika Niemela
    • 12
  • Alberto Pasqualin
    • 13
  • Andrey Golanov
    • 14
  • Bengt Karlsson
    • 15
  • Andras Kemeny
    • 16
  • Roman Liscak
    • 17
  • Bodo Lippitz
    • 18
  • Matthias Radatz
    • 19
  • Alessandro La Camera
    • 20
  • René Chapot
    • 21
  • Civan Islak
    • 22
  • Laurent Spelle
    • 23
  • Alberto Debernardi
    • 1
  • Elio Agostoni
    • 24
  • Martina Revay
    • 1
  • Michael K. Morgan
    • 25
  1. 1.NeurosurgeryGrande Ospedale Metropolitano NiguardaMilanItaly
  2. 2.NeuroradiologyMetropolitan Hospital NiguardaMilanItaly
  3. 3.Neurology, MethodologistIRCCS Istituto Mario NegriMilanItaly
  4. 4.NeurosurgeryCharitè UniversitatetsmedizinBerlinGermany
  5. 5.NeuroradiologyNational Institute of NeuroScienceBudapestHungary
  6. 6.RadiosurgeryOspedale Villa Maria di CotignolaRavennaItaly
  7. 7.NeurosurgeryUniversitaetsSpitalZurichSwitzerland
  8. 8.NeurosurgeryInselspitalBernSwitzerland
  9. 9.NeurosurgeryBurdenko HospitalMoscowRussia
  10. 10.Neurosurgery and NeuroradiologyUniversity HospitalLintzAustria
  11. 11.NeurosurgeryNational HospitalOsloNorway
  12. 12.NeurosurgeryUniversity HospitalHelsinkiFinland
  13. 13.NeurosurgeryOspedale Maggiore CivileVeronaItaly
  14. 14.RadiosurgeryBurdenko HospitalMoscowRussia
  15. 15.RadiosurgerySingapore Gamma Knife CenterSingaporeSingapore
  16. 16.RadiosurgeryThornbury Radiosurgery CentreSheffieldUK
  17. 17.RadiosurgeryNa Homolce HospitalPragueCzech Republic
  18. 18.RadiosurgeryBupa Cromwell HospitalLondonUK
  19. 19.RadiosurgeryRoyal Hallamshire HospitalSheffieldUK
  20. 20.RadiosurgeryGrande Ospedale Metropolitano NiguardaMilanItaly
  21. 21.NeuroradiologyKrupp HospitalHessenGermany
  22. 22.Neuroradiology, Cerrahpaşa Medical Facultyİstanbul UniversityIstanbulTurkey
  23. 23.NeuroradiologyBicetre University HospitalParisFrance
  24. 24.NeurologyGrande Ospedale Metropolitano NiguardaMilanItaly
  25. 25.NeurosurgeryMacquaire UniversitySydneyAustralia

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