O12/125 CHOICE, prospective multicenter study of endovascular treatment for cerebral AVMs treated with SQUID: clinical and angiographic results at 1 year

Introduction

Most brain arteriovenous malformations (bAVM) are or become symptomatic over time with a persistent risk of rupture. bAVM treatment remains challenging and standard practices continue to evolve.

Aim of Study

The purpose of this study is to assess the bAVM treatment with SQUID embolic agent by embolization alone or in combination with other treatments.

Methods

A European, prospective, observational, multicenter study including 21 centers was performed on patients with previously untreated bAVM followed for 1 year. The primary safety endpoint was the morbi-mortality assessed at the 3/6-month visit post endovascular phase or before any complementary treatment.

Results

Between May-2018 and August-2020, 109 patients were enrolled (mean age 46.3±15, 50.5% male). bAVM were located in the left side in 55% of the cases, in the supratentorial region in 76.1% and in the eloquent site in 57.8%. Most bAVMs were Spetzler-Martin grade I-II (67%). Mean bAVM diameter was 2.3±1.5 and the nidus was small (<3 mm) in 78.9% of cases. 80.7% of the patients had a baseline mRS score of 0–2. Most patients underwent embolization alone (80.7%) and 19.3% received complementary treatment (85.7% underwent neurosurgery and 14.3% radiotherapy). The morbi-mortality related to SQUID or the procedure was 6.4% at 3/6-month and decreased to 4.9% at 1 year. No mortality related to SQUID or the procedure occurred. At 3/6-month, 63.2% of patients treated with embolization alone achieved a complete occlusion.

Conclusion

These results reflect the use of SQUID in real-world conditions and confirm its safety and efficacy in the management of bAVM.

Disclosure of Interest

Nothing to disclose.