O-032 Treatment outcomes for ARUBA eligible brain arteriovenous malformations: a comparison of real world data from the NVQI-QOD AVM registry to the ARUBA trial

IntroductionSince the publication of the ARUBA trial, interventional management of cerebral arteriovenous malformations has become an area of debate. Treatment practices may have changed based on data from this recent trial which suggested that the risk of AVM treatment is greater than medical management in unruptured AVMs. To assess the ‘real world’ experience with interventional AVM outcomes, we compared outcomes of ARUBA eligible patients from the NVQI-QOD registry database to the ARUBA trial results.MethodsIn an IRB approved study, the NVQI-QOD AVM registry database was queried for treated patients between 2017 to present with the following inclusion criteria: age > 18 years, baseline mRS> 1, unruptured AVMs. 174/364 patients were ARUBA eligible and were included in the analysis. Patients were divided into embolization alone, microsurgery with or without embolization, and gamma knife radiation therapy with or without embolization. Primary outcomes of ischemic/hemorrhagic stroke or death were analyzed with a mean follow up time of 5.8 months (range 1 to 128 months).ResultsA total of 14 (8.0%) of patients that underwent any type of intervention suffered stroke or mortality. The risk of stroke or death was 6.8% (5 of 74) for microsurgery, 5.4% (2 of 37) for gamma knife, and 10.9% (7 of 64) for embolization alone. Annual stroke or death rates for all treatments were 7.5% (13 of 174) at one year and 0.57% (1 of 174) at 2 years.ConclusionARUBA eligible patients from the NVQI-QOD registry demonstrate a significantly lower risk of stroke or death with intervention of 8.0% (N=174) compared to the 30.7% (N=114) ARUBA trial interventional risk, and is nearly equivalent to the ARUBA trial medical management risk of 10.1% (N=109) over 33 months.DisclosuresN. Moore: 1;C;SNIS Joe Niekro Research Grant. R. Abdalla: None. T. Patterson: None. Y. Moazeni: None. P. Rasmussen: 2;C;Blockade Medical, Covidien/Medtronic, Stryker Neurovascular, Perflow Medical. 4;C;Perflow Medical. G. Toth: None. M. Bain: 2;C;Stryker Neurovascular. S. Ansari: None. S. Hussain: 2;C;Pulsar Inc.