Brain Arteriovenous Malformations: Status of Open Surgery after A Randomized Trial of Unruptured Brain Arteriovenous Malformations

Neurosurg Clin N Am. 2022 Oct;33(4):443-448. doi: 10.1016/j.nec.2022.05.006. Epub 2022 Sep 11.

Abstract

The results of "A Randomized Trial of Unruptured Brain Arteriovenous Malformations" (ARUBA) suggested that observation alone resulted in less morbidity and mortality than intervention for these lesions. These findings generated significant controversy throughout the cerebrovascular community and resulted in several subsequent studies investigating the role of microsurgical resection on ARUBA-eligible patients. Herein, we provide a brief overview of the ARUBA trial, its subsequent criticisms, the resultant publications challenging the findings in ARUBA, and discuss the available data regarding the effect ARUBA has had on arteriovenous malformation (AVM) treatments.

Keywords: ARUBA; Arteriovenous malformation; Cerebrovascular surgery; Intracranial hemorrhage; Ischemic stroke; Ruptured AVM; Unruptured AVM.

Publication types

  • Review

MeSH terms

  • Brain / pathology
  • Humans
  • Intracranial Arteriovenous Malformations* / surgery
  • Neurosurgical Procedures / methods
  • Radiosurgery* / methods
  • Randomized Controlled Trials as Topic
  • Treatment Outcome