The current clinical picture of cerebral proliferative angiopathy: systematic review

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art_WELK_The_creation_and_validation_of_a_short_form_2020.PDF.pdf (683.49 KB)
Citações na Scopus
11
Tipo de produção
article
Data de publicação
2020
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
SPRINGER WIEN
Autores
LIEM, Glaucia Lexy Jong
PASCHOAL, Eric Homero Albuquerque
Citação
ACTA NEUROCHIRURGICA, v.162, n.7, p.1727-1733, 2020
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background Cerebral proliferative angiopathy (CPA) is a rare subset of arteriovenous malformations (AVM). It has unique clinical presentation, angiographic characteristics, and pathophysiology which often brings challenges for the treatment. We aimed to define its epidemiology, pathophysiology are unknown, and best management strategies. Methods A systematic review was conducted according to the PRISMA guidelines. MEDLINE was searched for articles regarding CPA. Extracted data included epidemiological, clinical, and angiographical characteristics, treatment, and outcomes. Treatment was classified as conservative, radiosurgery, endovascular, decompression, and indirect vascularization. A meta-analytical approach was employed for description of the data as study-size adjusted percentages or weighted means, as appropriate. Results Thirty-three studies were analyzed, rendering a total 95 cases-half of which came from a single study. Patients were predominantly young (mean 23 years old) and female (60.0%) presenting with headaches (44.9%), seizures (37.1%), or transient ischemic attacks (33.7%). Hemorrhage was present in 18.0%, but rebleeding rates were as high as 67%. The majority of nidus were > 6 cm (52.5%) with hemispheric extension (73.0%). Capillary angioectatic appearance (85.7%), transdural supply (62.5%), and deep venous drainage (73.0%) were also frequent features. Most patients were treated conservatively (54.4%), followed by endovascular (34.2%). Indirect vascularization and radiosurgery were attempted in five and two patients, respectively. Mean follow-up was 110.8 patient-years. Neurological status improved in 50.7%, remained stable in 40.2%, and worsened in 9.0%. Conclusions Conservative and endovascular treatments seem adequate interventions, despite limited evidence. Complementary techniques can be used in patients throughout disease history, according to symptom-based, individualized approach. More studies are required for choosing interventions based on reliable long-term results.
Palavras-chave
Cerebral, Proliferative, Angiopathy, Cerebrovascular, Arteriovenous, Malformation
URI
https://observatorio.fm.usp.br/handle/OPI/36899
Referências
  1. Biasi PR, 2015, BRAZ NEUROSURG, V34, P82, DOI 10.1055/s-0035-1547393
  2. Bilaj F, 2016, NEURORADIOL J, V29, P336, DOI 10.1177/1971400916656486
  3. Vargas MC, 2011, J COMPUT ASSIST TOMO, V35, P33, DOI 10.1097/RCT.0b013e3181ff1e79
  4. CHIN LS, 1992, NEUROSURGERY, V31, P863
  5. Ducreux D, 2002, EUR RADIOL, V12, P2717, DOI 10.1007/s00330-001-1293-y
  6. Ellis MJ, 2011, J NEUROSURG-PEDIATR, V7, P15, DOI 10.3171/2010.10.PEDS10388
  7. Fierstra J, 2011, J NEUROSURG-PEDIATR, V8, P310, DOI 10.3171/2011.6.PEDS1170
  8. Giragani S, 2018, IEEE T IND APPL, P1
  9. Hong KS, 2010, J NEUROL NEUROSUR PS, V81, P36, DOI 10.1136/jnnp.2009.183277
  10. Kimiwada T, 2013, J STROKE CEREBROVASC, V22, P1432, DOI 10.1016/j.jstrokecerebrovasdis.2013.05.038
  11. Kono K, 2014, J NEUROSURG, V121, P1411, DOI 10.3171/2014.7.JNS132793
  12. Lasjaunias PL, 2008, STROKE, V39, P878, DOI 10.1161/STROKEAHA.107.493080
  13. Lawton MT, 2015, NAT REV DIS PRIMERS, V1, DOI 10.1038/nrdp.2015.8
  14. Li J, 2016, J NEUROL NEUROPHYSIO, V7, P394, DOI [10.4172/2155-9562.1000394, DOI 10.4172/2155-9562.1000394]
  15. Liu P, 2016, INTERV NEURORADIOL, V22, P101, DOI 10.1177/1591019915609784
  16. Lopci E, 2016, CLIN NUCL MED, V41, pE527, DOI 10.1097/RLU.0000000000001396
  17. Maekawa H, 2018, INTERV NEURORADIOL, V24, P713, DOI 10.1177/1591019918787265
  18. Marks MP, 2012, J NEUROINTERV SURG, V4, DOI 10.1136/neurintsurg-2011-010027
  19. Moher D, 2010, INT J SURG, V8, P336, DOI 10.1016/j.ijsu.2010.02.007
  20. Puerta P, 2017, PEDIATR NEUROSURG, V52, P214, DOI 10.1159/000459629
  21. Sakata H, 2016, J STROKE CEREBROVASC, V25, pE200, DOI 10.1016/j.jstrokecerebrovasdis.2016.07.042
  22. Somji M, 2019, NEUROSURG FOCUS, V46, DOI 10.3171/2018.11.FOCUS18529

Coleções
Artigos e Materiais de Revistas Científicas - FM/MNE
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InRad
Artigos e Materiais de Revistas Científicas - LIM/12
Artigos e Materiais de Revistas Científicas - LIM/25
Artigos e Materiais de Revistas Científicas - LIM/62