Objective: Brain arteriovenous malformations management remains controversial despite the numerous, available treatment options. Randomized controlled trials (RCTs) theoretically provide the strongest evidence for the assessment of any therapeutic intervention. However, poorly designed RCTs may be associated with biases, inaccuracies, and misleading conclusions. The purpose of our study is to assess reporting transparency and methodological quality of the existing RCTs.
Methods: A search was performed in the PubMed, Scopus, Embase, clinicaltrials.gov, and Cochrane databases. The search was limited to English literature. We included all published RCTs reporting on the management of unruptured brain arteriovenous malformations. The eligible studies were evaluated by 5 blinded raters with the CONsolidated Standards of Reporting Trials 2010 statement and the risk-of-bias 2 tool. The inter-rater agreement was assessed with the Fleiss' Kappa.
Results: A randomized trial of unruptured brain arteriovenous malformations (ARUBA) and treatment of brain arteriovenous malformations (TOBAS) trials were evaluated. ARUBA achieved high CONsolidated standards of reporting trials compliance, while TOBAS showed a moderate one. In ARUBA the introduction, discussion, and other information sections reached the highest compliance rate (80%-86%). The lowest rates were recorded in the results and the methods (62% and 73%, respectively). The inter-rater agreement was moderate to substantial (54.1% to 78.4%). All the examined studies demonstrated a high risk of bias, mainly related to ill-defined intended interventions, missing outcome data, and selection of the reported results.
Conclusions: Our study confirmed the high risk of bias mainly attributed to several protocol violations, deviations, minimal external validity and selection, attrition, and allocation biases of the ARUBA trial. Analysis of the TOBAS trial revealed a moderate overall reporting clarity and a high risk of bias.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.wneu.2022.07.043 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Unraveling the transcriptomic landscape of brain vascular cells in dementia: A systematic review.
Alzheimers Dement
January 2025
UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK.
Introduction: Cerebrovascular dysfunction plays a critical role in the pathogenesis of dementia and related neurodegenerative disorders. Recent omics-driven research has revealed associations between vascular abnormalities and transcriptomic alterations in brain vascular cells, particularly endothelial cells (ECs) and pericytes (PCs). However, the impact of these molecular changes on dementia remains unclear.
View Article and Find Full Text PDFRecurrence of chronic encapsulated hematoma following cyst formation after stereotactic radiosurgery for brain arteriovenous malformations: a case report.
Chin Neurosurg J
January 2025
Department of Neurosurgery, University Hospital Cruces, Bilbao, Basque Country, Spain.
Background: Delayed radiation-induced complications after stereotactic radiosurgery (SRS) for arteriovenous malformations (AVM) have scarcely been described in the literature, and their incidence, pathophysiology, and treatment remain unclear. Additionally, the literature regarding these complications is confusing. The authors present a well-documented case report describing these late complications, adding evidence to the possible common pathophysiological mechanism underlying them, and illustrating an effective treatment modality when they occur.
View Article and Find Full Text PDFThe central nervous system (CNS) parenchyma has conventionally been believed to lack lymphatic vasculature, likely due to a non-permissive microenvironment that hinders the formation and growth of lymphatic endothelial cells (LECs). Recent findings of ectopic expression of LEC markers including Prospero Homeobox 1 (PROX1), a master regulator of lymphatic differentiation, and the vascular permeability marker Plasmalemma Vesicle Associated Protein (PLVAP), in certain glioblastoma and brain arteriovenous malformations (AVMs), has prompted investigation into their roles in cerebrovascular malformations, tumor environments, and blood-brain barrier (BBB) abnormalities. To explore the relationship between ectopic LEC properties and BBB disruption, we utilized endothelial cell-specific overexpression mutants.
View Article and Find Full Text PDFBridging the gap: A scoping review of endovascular and microsurgical approaches to anterior ethmoidal dural arteriovenous fistulas.
Clin Neurol Neurosurg
January 2025
Department of Neurosurgery & Brain Repair, University of South Florida, Tampa, FL, USA. Electronic address:
Introduction: Dural arteriovenous fistulas (dAVF) are abnormal anastomoses between meningeal arteries and dural venous sinuses. Typically, dAVF treatment involves an endovascular or microsurgical approach. Anterior ethmoidal artery (AEA) dAVFs pose unique challenges due to their anatomy and location.
View Article and Find Full Text PDFEndoscopic third ventriculostomy for hydrocephalus accompanied by dural arteriovenous fistulae: a case report and literature review.
Acta Neurochir (Wien)
January 2025
Department of Neurosurgery, Kanazawa University, 13-1 Takara-machi, Kanazawa, 9208641, Ishikawa, Japan.
A 54-year-old man presented with gait disturbances, urinary incontinence, and headache for 6 months. Head computed tomography indicated several high-density mass lesions in the quadrigeminal cistern, causing occlusive hydrocephalus. Digital subtraction angiography confirmed tentorial dural arteriovenous fistulae (AVF).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!