Multimodality treatment for brain arteriovenous malformation in Mainland China: design, rationale, and baseline patient characteristics of a nationwide multicenter prospective registry

Chinese Neurosurgical Journal

Study Protocol

Dezhi Gao¹  Shibin Sun¹  Ali Liu¹  Xiangyu Meng²  Hengwei Jin²  Youxiang Li²  Fa Lin³  Yu Chen³  Ke Wang³  Shuai Kang³  Runting Li³  Qiang Hao³  Li Ma³  Xun Ye³  Kexin Yuan³  Hao Wang³  Zhipeng Li³  Debin Yan³  Haibin Zhang³  Heze Han³  Ruinan Li³  Shuo Wang⁴  Yuanli Zhao⁴  Xiaolin Chen⁵  Yang Zhao⁶  Yukun Zhang⁶  Weitao Jin⁶ 

[1] Department of Gamma-Knife Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;China National Clinical Research Center for Neurological Diseases, Beijing, China;Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;Stroke Center, Beijing Institute for Brain Disorders, Beijing, China;Department of Neurosurgery, Peking University International Hospital, Peking University, Beijing, China;

关键词: Arteriovenous malformation;    Embolization;    Microsurgery;    Multidisciplinary assessment;    Outcomes;    Radiosurgery;    Registry;    Rupture;   

DOI  :  10.1186/s41016-022-00296-y

 received in 2022-06-26, accepted in 2022-08-16,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundBrain arteriovenous malformation (AVM) is an important cause of hemorrhagic stroke in young adults, which can lead to severe neurological impairment. The registry of Multimodality treatment for brain ArTeriovenous malformation in mainland CHina (MATCH) is a national prospective registry to identify the natural history of AVMs in Asian population; to investigate traditional and emerging hemorrhagic predictors; and to explore the superiority of the multidisciplinary assessment in improving the long-term outcomes. MethodsConsecutive AVM patients will be enrolled from 52 participating hospitals in mainland China. Baseline demographic, clinical and imaging data will be collected prospectively. Conservation, microsurgery, embolization, stereotactic radiosurgery (SRS), and multimodal strategies are all included in this study. Patients will be divided into experimental and control group according to whether the treatment protocols are formulated by multidisciplinary team. Neurofunctional status, subsequent hemorrhage, seizure, and novel neurofunctional deficit will be queried at 3 months, annually (1 and 2 years), 3 years, and 10 years follow-up.ResultsBetween August 2011 and April 2021, 3241 AVMs were enrolled in 11 participating sites. Among them, 59.0% were male with an average age of 28.4 ± 14.6 years, 61.2% had rupture history and 2268 hemorrhagic events occurred before admission. The median Spetzler-Martin grade and Lawton-Young grade was 3 and 5, respectively. Microsurgery is the dominant strategy (35.7%), with a similar proportion of embolization, SRS, and a combination of both (12.7%; 14.8%; 11.8%; respectively). Among them, 15.43% underwent multidisciplinary assessment and received standardized treatment. At the most recent follow-up, 7.8% were lost and the median follow-up duration was 5.6 years.ConclusionsThe MATCH study is a large-sample nationwide prospective registry to investigate multimodality management strategy for AVMs. Data from this registry may also provide the opportunity for individualized risk assessment and the development of optimal individual management strategies.Trial registrationClinicalTrials.gov Registry (NCT04572568).

【 授权许可】

CC BY   
© The Author(s) 2022

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