Burks JD, Luther EM, Govindarajan V, et al. - In patients undergoing endovascular intervention for unruptured brain arteriovenous malformation, the risk of perioperative stroke is reliant on Spetzler-Martin grade and posterior-circulation arterial supply. Stroke risk may also be influenced by differences in regional treatment paradigms.

• No previous analysis focused on risk factors for perioperative stroke in patients undergoing endovascular therapy in the ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations) Trial.

• This study involved 64 ARUBA patients; 159 interventions were conducted, and 26 (16%) procedures led to stroke within 48 hours of treatment.

• In those who received endovascular intervention, increased perioperative stroke risk was found in relation to posterior cerebral artery supply (adjusted odds ratio, 4.42) and Spetzler-Martin grades 2 and 3 arteriovenous malformation (adjusted odds ratio, 7.76 and 9.64, respectively).

• A significantly lower stroke risk was observed in patients treated in the United States or Germany vs those treated in other countries (adjusted odds ratio, 0.18).