Role of frameless stereotaxy in the surgical treatment of cerebral arteriovenous malformations: Technique and outcomes in a controlled study of 44 consecutive patients

Stephen M. Russell, Henry H. Woo, Seth S. Joseffer, Jafar J. Jafar, John E. Wanebo, Robert F. Spetzler, Robert E. Replogle, Duke S. Samson, Kazuhiko Nozaki, Nobuo Hashimoto, John M. Tew, Albino Bricolo, Massimo Gerosa

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

OBJECTIVE: To describe a frameless stereotactic technique used to resect cerebral arteriovenous malformations (AVMs) and to determine whether frameless stereotaxy during AVM resection could decrease operative times, minimize intraoperative blood losses, reduce postoperative complications, and improve surgical outcomes. METHODS: Data for 44 consecutive patients with surgically resected cerebral AVMs were retrospectively reviewed. The first 22 patients underwent resection without stereotaxy (Group 1), whereas the next 22 patients underwent resection with the assistance of a frameless stereotaxy system (Group 2). RESULTS: The patient characteristics, AVM morphological features, and percentages of preoperatively embolized cases were statistically similar for the two treatment groups. The mean operative time for Group 1 was 497 minutes, compared with 290 minutes for Group 2 (P = 0.0005). The estimated blood loss for Group 1 was 657 ml, compared with 311 ml for Group 2 (P = 0.0008). Complication rates, residual AVM incidences, and clinical outcomes were similar for the two groups. CONCLUSION: Frameless stereotaxy allows surgeons to 1) plan the optimal trajectory to an AVM, 2) minimize the skin incision and craniotomy sizes, and 3) confirm the AVM margins and identify deep vascular components during resection. These benefits of stereotaxy were most apparent for small, deep AVMs that were not visible on the surface of the brain. Frameless stereotaxy reduces the operative time and blood loss during AVM resection.

Original languageEnglish (US)
Pages (from-to)1108-1118
Number of pages11
JournalNeurosurgery
Volume51
Issue number5
DOIs
StatePublished - Nov 1 2002

Keywords

  • Arteriovenous malformations
  • Computer
  • Frameless stereotaxy
  • Stereotaxy

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Russell, S. M., Woo, H. H., Joseffer, S. S., Jafar, J. J., Wanebo, J. E., Spetzler, R. F., Replogle, R. E., Samson, D. S., Nozaki, K., Hashimoto, N., Tew, J. M., Bricolo, A., & Gerosa, M. (2002). Role of frameless stereotaxy in the surgical treatment of cerebral arteriovenous malformations: Technique and outcomes in a controlled study of 44 consecutive patients. Neurosurgery, 51(5), 1108-1118. https://doi.org/10.1097/00006123-200211000-00002