Literature Review

Functional impairments for outcomes in a randomized trial of unruptured brain AVMs

Selected in Neurology by CAROFF Jildaz

Authors: Mohr JP, Overbey JR, von Kummer R, Stefani MA, Libman R, Stapf C, Parides MK, Pile-Spellman J, Moquete E, Moy CS, Vicaut E, Moskowitz AJ, Harkness K, Cordonnier C, Biondi A, Houdart E, Berkefeld J, Klijn KJM, Barreau X, Kim H, Hartmann A

Reference: Neurology. 2017 Sep 6;:10.1212/WNL.0000000000004532–9

Published: September 2017

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Friday 08 September 2017

Yesterday, the journal Neurology published a more detailed analysis of the controversial ARUBA trial. Clinical functional impairment of the primary endpoint events (i.e. stroke severity) as well as the association with Spetzler-Martin grade were not analyzed in detail in the earlier publication.

Three important points here:

1) Patients in the medical management arm were less likely to experience primary outcomes (i.e. death or stroke) with functional impairment (as defined as an mRS score >2) than those who underwent intervention after a median follow-up of 33 months

2) The above was found to be the case regardless of Spetzler-Martin grades 

3) These results applied for both randomized and treated patients

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