Turkish Neurosurgery 2024 , Vol 34 , Num 5
Hybrid Operating Room for the Treatment of Spetzler-Martin Grade III-V Brain Arteriovenous Malformation: An Institutional Experience
Jiao CHENG1,Bingwei SONG2,Liang HE2,Ke YAN2,Linhai SHEN2,Kai HU1,Yong ZHEN2
1The Yangzhou School of Clinical Medicine of Dalian Medical University, Department of Neurosurgery, Yang Zhou 225000, China
2Northern Jiangsu People?s Hospital Affiliated to Yangzhou University, Department of Neurosurgery, Yang Zhou 225000, China
DOI : 10.5137/1019-5149.JTN.45444-23.1 AIM: To report our institutional experience of the one-stop treatment of Spetzler?Martin grade (SMG) III?V brain arteriovenous malformations (BAVMs) in a hybrid operating room.

MATERIAL and METHODS: Clinical data obtained from all the patients with SMG III?V BAVMs who underwent one-stop treatment in a hybrid operating room were analyzed. The measures included imaging characteristics, intraoperative blood loss, postoperative complications, residual lesions, and the presence of postoperative recurrence. Outcomes were assessed using the Glasgow outcome scale (GOS) score at six months post-surgery.

RESULTS: A total of 16 patients were included in this study, 7 of whom underwent endovascular embolization followed by microsurgical resection and 9 underwent intraoperative cerebral angiography-assisted microsurgery. The average intraoperative blood loss was 473.3 mL. A remnant of BAVMs was found on the intraoperative cerebral angiography of one patient. Two patients underwent decompressive craniectomy due to postoperative cerebral swelling, including one patient with occipital lobe cerebral infarction and aphasia. No mortality was recorded. At the six-month postoperative follow-up visit, the GOS scores were 3 (n=4, 25.0%), 4 (n=4, 25.0%), and 5 (n=8, 50.0%). No recurrence was noted on brain digital subtraction angiography (DSA) in any of the postoperative reexaminations.

CONCLUSION: A hybrid operating room can fully combine the advantages of microsurgery and endovascular interventions, allowing for a high resection rate in the surgical treatment of SMG III?V BAVMs and a low rate of postoperative complications. Keywords : Brain arteriovenous malformation, Hybrid operating room, Interventional embolization

Corresponding author : Yong ZHEN, 18051060868@yzu.edu.cn