For people with a brain arteriovenous malformation, a congenital vascular system defect, fate has a name: stroke. To avoid this risk, patients sometimes undergo interventions to remove the malformation. But is this very beneficial?
Not necessarily. According to an international clinical trial co-directed by researchers at the University of Montreal Hospital Research Centre (CRCHUM), interventional treatment – by neurosurgery, neuroradiology or radiation therapy – could be more dangerous than the disease itself.
Christian Stapf, a vascular neurologist at the CHUM and the co-author of the article, and his colleagues show that the risk of having a stroke or dying falls by 68 per cent when doctors let the malformation follow its natural course.
“In other words, the risk of patients having a stroke or dying is at least three times lower,” said Stapf, a researcher at the CRCHUM and professor at Université de Montréal.
“We wondered what was better for the patient: to remove the malformation to prevent a stroke or to live with the malformation for several years? The results of ourstudy are clear: in the long term, standard medical care is more beneficial for the patient than any intervention. This certainly shakes up conventional thinking about how to prevent stroke in these patients.”
